Dáil Éireann - Volume 313 - 29 March, 1979

Ceisteanna—Questions. Oral Answers. - Ophthalmic Services.

14. Mr. M.P. Murphy asked the Minister for Health if he will make a detailed statement on the availability of ophthalmic services to insured contributors and medical card holders.

Mr. Haughey: In-patient ophthalmic treatment services are provided free of charge by health boards for medical card holders. Insured persons, other than those excluded because their incomes exceed the present limit of £3,000 per annum, are also entitled to in-patient ophthalmic services. From 6 April all persons will be entitled to free hospital in-patient services in public wards, but those earning £5,500 or more will have to pay consultants' fees. In general, hospital ophthalmic services are operating satisfactorily.

Certain insured persons are also entitled to optical benefits under a scheme operated by the Department of Social Welfare. The benefits available consist of a free eye examination or sight test plus free spectacles of a specified type or a subvention towards the cost of other spectacles. To qualify, an insured person must have 26 employment contributions in the case of a person under 21 years or, in other cases, 156 contributions of which 26 must have been paid or credited in the relevant contribution year. This scheme is operated through ophthalmologists, ophthalmic opticians and dispensing opticians, in private practice. The scheme is generally regarded as providing a readily available service for eligible insured persons.

Medical card holders are also entitled free of charge to out-patient ophthalmic service provided by health boards. Where prescribed, spectacles are also provided free of charge. This service is operating under considerable pressure and many patients experience delay in obtaining services.

As I have already indicated to the [842] House, I am not satisfied with certain aspects of our existing ophthalmic service. The Government intend to divert resources towards their improvement, and I am actively considering the most appropriate manner in which to effect the necessary improvements.

Mr. M.P. Murphy: Is the Minister aware that as the scheme operates at present, whatever about its operation subsequent to 6 April, it is impossible for many insured contributors and medical card holders to get ophthalmic services and, as a result, many such people have had to go as private patients and pay?

An Ceann Comhairle: That is interesting information, but the Deputy should ask a question.

Mr. M.P. Murphy: I am asking is the Minister aware that this is happening. It should not happen, but it is happening. Is he also aware that delays of more than 12 months and up to two years are the order of the day for medical card holders awaiting consultations with ophthalmic surgeons? Surely the Minister will agree that is most undesirable and that the ophthalmic service is not working smoothly. Indeed it is working most inefficiently.

Mr. Haughey: I have already accepted that the service is not satisfactory.

Mr. Boland: In relation to the different categories, would the Minister confirm that the situation from 6 April next will be that all insured persons and their dependants on an income under £5,500 will be entitled to ophthalmic in-patient and out-patient services under their eligibility under the Health Act but that those people over £5,500 would be required to pay the ophthalmic specialist's costs for in-patient purposes?

Mr. Haughey: Only.

Mr. Boland: For out-patient purposes they would not have cover under the Health Act but they might have cover under the Social Welfare Act?

[843] Mr. Haughey: Yes.

Mr. Boland: Would that mean that the category of people under £5,500 and their dependants would be insured for in-patient and out-patient services under the Health Act, or would the situation still obtain that only the social welfare insured contributor would be covered for eligibility for out-patient services under the Social Welfare Act?

Mr. Haughey: I am not clear as to the Deputy's difficulty. The ophthalmic services will be the same as everything else. The persons in what we call category II, those with corresponding entitlement to what is limited eligibility at present, will be entitled to full hospital services, in-patient and out-patient, except in so far as consultants' fees are concerned.

Mr. Boland: Category II?

Mr. Haughey: Yes.

An Ceann Comhairle: Question No. 15. We are making very slow progress.

Mr. Boland: There is a great deal of confusion in relation to this.

An Ceann Comhairle: There are a great deal of health questions on the Order Paper.

Mr. Boland: Is the Minister quite certain about category II people with the exclusion of specialists fees? Surely category II people ought to be covered for specialist fees for in-patient purposes?

Mr. Haughey: I am sorry; category III people. Category III persons will be entitled to all services free except consultants. Category II people, of course, will be covered for in-patient and out-patient hospital services, including their consultants' fees.

Mr. Boland: Will dependants of category II persons be covered for out-patient services?

Mr. Haughey: Yes.

[844] Mr. Boland: Under the Health Act?

Mr. Haughey: Yes.

Mr. Boland: Although they would not have the same cover under social welfare eligibility?

Mr. Haughey: Yes.

Mr. Boland: That clarifies it; thank you.