Thousands on breadline 'refused medical cards'

More than a quarter of a million people at risk of poverty could not get a medical card because Government rules found they earned too much, it was claimed today.

Even though they are living on the breadline, the Combat Poverty Agency said strict guidelines on who qualifies for free health care had frozen them out.

The alarming figures were recorded by experts from the Economic and Social Research Institute think-tank in 2005.

Helen Johnston, director of Combat Poverty, warned that poverty and poor health go hand in hand.

“Adverse social conditions including low income, education, housing and limited access to quality health services affect people’s health status,” she said.

“Those who are poor experience worse health and die younger than those who are wealthy.”

The ESRI research found 229,000 people at risk of poverty in Ireland in 2005 did not have a medical card and that almost 43,000 of these people were living in consistent poverty.

Combat Poverty accepted changes had been made to rules on who qualifies over the last two years but warned it is not clear whether those most at risk have benefited.

“There is a need to ensure that the medical card threshold is indexed to the poverty line so that people on low incomes can attend their GP when they need to, regardless of their ability to pay,” Ms Johnston said.

The agency launched its health policy statement at its national health conference in Croke Park, Dublin and said increasing access to medical cards is the most immediate and effective way of reducing health inequalities and improving access to services for people on low incomes.

Ms Johnston said medical card income thresholds should be set above the poverty line so everyone living in poverty is eligible.

At present, the earnings threshold for a medical card is €184 per week, €25 less than the €209 level at which people are considered to be at risk of poverty.

Combat Poverty also want common waiting lists for all patients introduced with no difference in timing or the type of care provided in order to make the health system fairer.

“Achieving better health requires services that are people-centred, accessible on the basis of need rather than ability to pay and deliver in an integrated manner,” Ms Johnston said.

“Deprived urban and rural areas should be prioritised for the allocation of primary care teams. Local communities should be involved in the development of health needs assessments and in the design and delivery of primary care services.”

Professor Richard Layte, co-author the ESRI report, said more policies involving a number of departments had to be introduced to tackle the problems in the health service.

“Policies to reduce socio-economic inequalities in health cannot be dealt with by the Department of Health and Children alone and policies to reduce inequities will need to be formulated and implemented on a cross departmental basis, preferably with strong inter-departmental co-ordination,” the professor said.

The ESRI study, ’Poor Prescriptions: Poverty and access to community health services’, examines the use of primary health care services, including GPs, dentists and opticians, among the Irish population.

It found the pattern of health closely follows social inequalities in terms of income, education, social class and poverty. It also found GP visits are highest among lower income groups and these groups tend to be older and have much worse health.