Dáil Éireann - Volume 605 - 28 June, 2005

Written Answers - Long-Term Illness Scheme.

  242. Mr. Haughey asked the Tánaiste and Minister for Health and Children if she will classify asthma as a long-term illness in order that the range of products for the treatment of asthma, such as inhalers, are made available free of charge to all asthma sufferers if they have a medical card or not or if they can avail of the drugs payment scheme or not for this purpose; and if she will make a statement on the matter. [22528/05]

  270. Mr. Crawford asked the Tánaiste and Minister for Health and Children if she will consider providing full medical card services to all those with chronic asthma; her views on whether this is a long term illness causing serious problems for the patients concerned often leading to hospi[652] talisation if primary care and medication is not available; and if she will make a statement on the matter. [22705/05]

  Ms Harney:I propose to take Questions Nos. 242 and 270 together.

Under the 1970 Health Act, the Health Service Executive may arrange for the supply, without charge, of drugs, medicines and medical and surgical appliances to people with a specified condition, for the treatment of that condition through the long-term illness scheme, LTI. The LTI does not cover GP fees or hospital co-payments. The conditions are: mental handicap, mental illness — for people under 16 only, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, diabetes mellitus, diabetes insipidus, haemophilia, cerebral palsy, epilepsy, multiple sclerosis, muscular dystrophies, Parkinsonism, conditions arising from thalidomide and acute leukaemia. Parkinsonism, acute leukaemia, muscular dystrophies and multiple sclerosis were added to the scheme in 1975. There are currently no plans to amend the list of eligible conditions.

The medical card, GMS, and drugs payment, DPS, schemes provide assistance towards the cost of approved drugs and medicines for people with significant ongoing medical expenses. People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. Non-medical card holders, and people with conditions not covered under the LTI, can use the drugs payment scheme, DPS. Under this scheme, no individual or family unit pays more than €85 per calendar month towards the cost of approved prescribed medicines. There is a range of asthma products, such as inhalers, on the common list of reimbursable drug products for the GMS and DPS.

Decisions on individual eligibility for a medical card are solely a matter for the Health Service Executive. In determining eligibility, for people other than those aged over 70, the applicant’s financial circumstances are considered and income guidelines are used. However, where a person’s income exceeds the guidelines, a medical card may be granted if it is considered that medical needs or other circumstances would justify this. Medical cards may also be issued to individual family members on this basis. There are currently no plans to change this position.

In November 2004, I announced revised medical card income guidelines, which increased by 7.5%, together with significant rises in respect of dependants, with a view to extending the number of medical cards by 30,000 in 2005. These guidelines have been in operation since January 2005. The introduction of the GP visit card will extend eligibility for a patient holding such a card to general practitioner services under the general medical services scheme. Such a person’s income can be up to 25% in excess of the income guidelines used for the assessment of eligibility for medical [653] cards. In addition, the basis for assessing an applicant’s income has been changed to a disposable income basis, that is income after tax and PSRI, including allowance for childcare, rent or mortgage and the cost of travel to work. This will mean that more individuals and families will be eligible, the assessment process will be fairer and more user-friendly and administrative arrangements will be simplified and streamlined.