There is an urgent need to reform the medical card system and to extend its benefits to those low-income families who are finding it impossible to access proper medical care.
There has been a grudging official recognition for years now that the cost of private treatment in a GP's surgery has placed it in the "luxury" category for many families, with the result that young children and their parents frequently do not receive early or adequate attention.
The roots of the problem can be traced back to a pre-election decision by the Coalition Government to give free medical cards to all those over 70 years of age in 2001. The cost of the new scheme was far greater than anticipated. GPs received a capitation fee for the over-70s which was four times greater than that allowed for ordinary card-holders. In order to save money, the Government then froze the qualifying income limit for ordinary medical cards and, as normal pay increases took effect, the number of people qualifying fell rapidly.
The Labour Party has estimated that the number of people who would qualify for medical cards on a means tested basis has dropped by 200,000 since the Government came to power in 1997. This figure is made up of more than 100,000 people who have lost their entitlements through income increases and a similar number of citizens over 70 years of age who would not qualify if they were means tested. This transformation has taken place in spite of a Government commitment in the last general election campaign to increase the number of medical card holders by 200,000.
A Government-established agency, Comhairle, will recommend today that income limits for medical card eligibility should be increased immediately. It will also propose the establishment of an independent appeals system to deal with those people who have been refused medical cards. It will also identify other problems with the system. The pressing nature of the situation has been recognised by the Tánaiste and new Minister for Health, Ms Harney. Earlier this week, she indicated that extra resources would be provided for the medical card scheme in the forthcoming Estimates. But she ruled out the introduction of a universal medical card system on the grounds that the State should not have to pay for well-off, healthy people. There is an inconsistency in the Tánaiste's position, even if the cost factor of a universal system raises questions of affordability. Many of those over 70 years of age who presently qualify for medical cards are both healthy and well-off. In order to be equitable, a means-tested system should apply to everyone.