The income limits for medical card eligibility should be increased immediately, a Government-established agency will recommend this week.
In a report to be published on Thursday, it is understood that Comhairle, a statutory agency which supports the provision of information to the public through a nationwide network of Citizens Information Centres, will also recommend that an independent appeals system be established without delay for those refused medical cards.
Its recommendations are based on feedback from its citizen's advice centres, which received more than 34,000 queries from the public about medical cards last year.
The report is expected to say that people whose only income is from social welfare are now being refused medical cards and that mothers, without medical cards, are neglecting their own health to ensure they can pay for their children to see a doctor. Even families who qualify for the Back to School Clothing and Footwear Allowance are being denied medical cards.
It will recommend an objective assessment of the income required to meet GP and related bills.
Furthermore, the report will refer to the fact that 100,000 fewer people hold medical cards now than they did in 1997, when the Government came to power. And while it estimates the cost of medical care rose by 181 per cent between 1993 and 2004, it will say the income limit required for a couple with two children to qualify for medical cards increased by just 40 per cent over the same period.
The agency has identified several problems with the medical card system, including the fact that one's entitlement to a medical card is not clear or consistent and that the discretion available to health boards to offer cards to some families on hardship grounds is not sufficiently publicised.
Furthermore, it will say there is very little information available on how this discretion is exercised or on the numbers who have availed of it.
Meanwhile, the Labour Party will today publish what it describes as a detailed study of the impact of medical bills on families who do not qualify for a medical card.
It says it also has new figures that show the decline in medical card numbers since the Government took office in June 1997 is even greater than previously thought.
The new Minister for Health, Ms Harney, has said she intends to raise the income threshold for qualifying for a medical card during her term of office at the Department. But previous commitments by the Government to do so in the 2001 National Health Strategy and in its Programme for Government have so far not been honoured.
Ms Harney is on record as saying the income threshold for qualifying for a medical card is "far too low" and "has slipped back enormously in recent years". She said: "It will be a priority of mine to change the threshold."