Almost 250,000 people at risk of poverty were unable to get a medical card in 2005 because their incomes were just above the eligibility threshold, new figures show.
The Combat Poverty Agency (CPA) said income thresholds for the medical card needed to be increased urgently. It insisted this was the most immediate and effective measure that could be taken to reduce health inequalities and improve access to health services for people on low incomes.
New research published by the agency yesterday also shows that the pattern of ill-health among the population closely follows the pattern of social inequalities across society.
The research, undertaken by the Economic and Social Research Institute (ESRI), found that the level of GP use was highest among lower income groups and that these groups tended to be older and were in worse health.
In a health policy statement published yesterday, the agency said a range of measures could help achieve more equitable access to better health services for people living in poverty.
"Poverty and poor health are interlinked," said Helen Johnston, director of the Combat Poverty Agency. "Adverse social conditions including low income, education, housing and limited access to quality health services affect people's health status. Those who are poor experience worse health and die younger than those who are wealthy."
She said that achieving better health required services that were people-centred, accessible on the basis of need rather than ability to pay and delivered in an integrated manner.
"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," she said.
Ms Johnston quoted recent research which shows that 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.
While there have been changes in eligibility thresholds for medical cards since then, Ms Johnston said it was not clear whether those most at risk had benefited.
Recommendations: health policy
- An increase in the medical card income threshold above the poverty line so everyone living in poverty is eligible for a full medical card. At present, the income 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".
- A common waiting list for all patients with no difference in timing or the type of medical care provided to make the health system more equitable.