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Dáil
‹ Ceisteanna—Questions. Oral Answers. - GMS Comprehensive Medical Care.

Means testing for restored medical cards

Summary

The Minister said estimating the cost of means-testing affected students would require an unjustified study, though costs varied with health-board systems. He said boards had been advised to give hardship cases special consideration and assess applications using evidence of income and eligibility; students without means could qualify, but entitlement was not automatic.

asked the Minister for Health the average cost of means testing a person between the ages of 16 and 25 who has applied for the restoration of a medical card on income grounds.

Comment on this

The cost of means testing a person who has applied for restoration of a medical card would be made up mainly of the labour cost of the staff involved in processing the application together with cost of postage, paper and printing. A special study would be required in order to assemble information on the work involved in dealing with such applications from persons between the ages of 16 and 25 years who are affected by the terms of the Health Services (No. 3) Regulations, 1983. I do not think that the cost of such a study would be justified.

Comment on this

It is extraordinary that health boards who have been dealing with assessment of persons for means test and so on for many years have not been able to develop cost effectiveness. Could the Minister give an estimate of what the cost would be in view of the fact that it costs £50,000 to send out a single letter notifying students that their cards are being withdrawn?

Comment on this

The total cost involved is a very tentative estimate spread over all the health boards. In some health board areas, however, the register is fully computerised, it is merely a question of a print-out and postage. In that case the cost would be minimal and most of our health boards are highly efficient in that regard.

Comment on this

Has the Minister's Department issued any snoop rules to the people who are involved in this assessment?

Comment on this

What kind of rules?

Comment on this

Snoop rules.

Comment on this

The Coalition have been accused of many things but we did not inherit those rules.

Comment on this

The Minister has a snoop in the Department of Social Welfare.

Comment on this

I should like to meet him.

Comment on this

There is refined and advanced snooperism.

Comment on this

The Minister referred to guidelines issued to health boards concerning applications from students for restoration of medical cards. Could he indicate what these guidelines are and could they be made available to Deputies?

Comment on this

Regulations have been issued and consultations have taken place with the chief executive officers of the health boards. In cases of hardship they have been advised that very special consideration should be given. After all the controversy over the past month, in fact only a couple of hundred cards have been withdrawn and great care is being exercised by the health boards not to indulge in unilateral action. People will be given a chance to state their case.

Comment on this
Denis Gallagher Mr. D. Gallagher Fianna Fáil

If the handing out of medical cards is decided on means, how can the Minister justify this decision in the case of students who have no means?

Comment on this

If a health board are satisfied that a student has no means from his parents a medical card will be issued. The degree of hypothetical complication introduced by Deputies is extraordinary and intriguing. If a student says he has no income and the health board are satisfied that that is so he will get a medical card provided he furnishes proof as to his lack of income. It is reminiscent of the small-holders' allowance. We must have proof for assessment and there will no longer be automatic entitlement by virtue of some unknown criteria.

Comment on this

The Minister said that if a student claims he has no income from parents he will be treated as having no income. Will this apply regardless of whether the student is living at home or not?

Comment on this

I can only lay down regulations in flexible terms. Responsibility rests with the CEOs of the health boards — and rightly so — of interpreting the regulations. That is what they are now doing and I have not heard that they are draconian in that regard. After all, 40 per cent of the population have medical cards.

Comment on this

That is a U-turn.

Comment on this

Is the Minister saying that health boards should accept the word of students that they have no income from their parents whether they live at home or not?

Comment on this

Health boards do not accept anybody's word. They require evidence of income and eligibility and then they make their assessment. Because people fill in a form with "nil" under "income" it does not automatically give them entitlement to free services. There must be proof. There has to be information and the ultimate criterion is the medical card number of the family.

Comment on this