Basis for excluding students from medical cards
The Minister argued that automatic medical-card entitlement for dependent students regardless of family means was unjustified and said medical needs had been considered. Deputies challenged the policy as unfair and potentially harmful, citing family anomalies and urging suspension and talks; the Minister defended the decision, while the Chair repeatedly curtailed the exchanges.
asked the Minister for Health the reason he has decided to exclude students over the age of 16 years whose parents are not medical card holders from treatment under the general medical services scheme; and the medical reasons that were considered before taking this decision.
Comment on this
The present economic situation has made it necessary to examine critically the costs of providing our health services. In the light of this economic climate the granting of medical cards to students and other young dependant adults without reference to their parents' financial circumstances was considered to be unjustified. Such persons whose parents have medical card eligibility will retain their medical cards.
The medical needs of those from whom medical cards were withdrawn was taken into consideration and special provision was incorporated in the regulations whereby the service would still be provided free of charge if the chief executive officer of the appropriate health board considered that its withdrawal would cause undue hardship. In addition, it was provided that persons from whom medical cards were withdrawn under the regulations would retain their entitlement to free hospital services, both inpatient and outpatient including free consultant services.
Comment on this
In his attempt to remove one anomaly, has the Minister created another anomaly within families? Students over the age of 16 on AnCO courses, irrespective of their parents' incomes, will be eligible for medical cards whereas brothers and sisters of the same age attending third level colleges will be ineligible if the parents do not hold medical cards.
Comment on this
It was anomalous that a person drawing unemployment assistance was obliged to go to the local employment exchange, complete the form and return it to the health board as proof of his income prior to the issue of a medical card while other members of the family, even those students with part-time employment, automatically had medical cards. In my view, the removal of that anomaly was of greater benefit.
Comment on this
In the interest of a peaceful settlement of this matter and to remove the growing alienation among students, would the Minister not agree that the issuing of this directive has been a very blunt instrument? If he suspended the implementation of the regulation and got down to serious talks about these anomalies with students' representatives that would be a constructive way towards a resolution of what could be a very serious matter.
Comment on this
It is far more serious when politicians indulge in special pleading, for example, when they visit young people in prison and indulge in special pleading on their behalf. The reason young people are alienated and disappointed in politicians is that they are not told the truth about the realities of the situation by all politicians. The choices facing me were that I could impose charges on out-patients; I could insist on everybody, including students, paying for full consultant services, irrespective of their incomes; I could have proposed charging students availing of public wards or, I could have allowed them retain their medical cards and impose a charge on every prescription. I did not do any of those things. Instead I decided to introduce a measure which would not cause hardship for students. A sum of £2.5 million has been saved and I deliberately transferred £500,000 of that money to the elderly, giving for the first time in the history of the State, additional income eligibility for people over the age of 65 and 80 years of age, people who are in far greater need——
Comment on this
Did the Minister meet the students in this House on 27 October and promise not to withdraw their medical cards?
Comment on this
We have spent 30 minutes on six questions. I have called Deputy McCarthy for a final supplementary and I am sticking to that.
Comment on this
Arising out of the Minister's earlier remarks that he would not withdraw medical cards——
Comment on this
I am sure the Deputy will find another way of asking her questions on some of the numerous subsequent questions on the Order Paper.
Comment on this
Not even all your charm could persuade me to let you ask another supplementary question.
Comment on this
I am calling No. 7. I have done my best to let Deputy McCarthy have a final supplementary, but I cannot. I am calling Question No. 7.
Comment on this
Is the Minister not torpedoing his entire health policy — in which he suggests that people should have out-patient treatment as much as possible — by the introduction of this regulation because this will ensure that students will go to casualty departments of hospitals rather than resort to general practitioners, costing a lot more, when probably they will be admitted needlessly as a result? Would the Minister say whether he has considered the facts, that young students are indifferent about their health, because of their immature age, that they tend to regard themselves as normally healthy? For that reason they will be reluctant to go to doctors but, as a result of the Minister's new regulation, they will have the added obstacle that they will have to have emergency money in their pockets to finance any health problem as it arises? Would the Minister say whether he has considered these facts?
Comment on this
In taking this decision I have also considered the fact that by and large £2 million goes to doctors and pharmacists in relation to what might be called casual income for them — which they will no longer have — and a lot of the arguments I am receiving are coming from that direction, not from the students.
