asked the Minister for Health if he will arrange for patients with coeliac disease to obtain gluten-free foods free of charge.
15.
Ceisteanna—Questions. Oral Answers. - Coeliac and Heart Disease Patients.
14.
asked the Minister for Health if he will consider including free medicines for patients who are suffering from heart disease on the list of free drugs.
16.
asked the Minister for Health if coeliac disease is included in the special list of long-term illnesses.
17.
asked the Minister for Health if free medicines for patients with coeliac and heart disease will be introduced shortly, in view of the heavy cost to patients at present of drugs and medicines.
I propose, with the permission of the Ceann Comhairle, to take Questions No. 14 to 17 together.
Persons covered by medical cards may obtain prescribed medicines free of charge. In the case of coeliac disease this includes certain gluten-free foods and, of course, drugs needed for heart conditions are covered.
Persons with limited eligibility are entitled to claim a refund of the cost of prescribed medicines in excess of £6.50 for a calendar month. This scheme also covers foods prescribed for persons with coeliac disease and drugs for heart conditions. Next April entitlement to the latter scheme will be extended to the remainder of the population.
Coeliac disease is not included in the prescribed list of long term illnesses and while I have no proposal at present to extend that list this scheme will be reviewed again before the end of the year.
In view of the great expense incurred and the long-term treatment involved for patients suffering from heart disease would the Minister not consider that it might alleviate some of the anxiety and distress caused them by (a) the rather cumbersome and over-elaborate method of explaining the cost of the drugs and (b) the anxiety in the initial stages of the disease itself and the anxiety overall associated with it? Would it not be more facile for the Minister to give carte blanche to patients suffering from heart disease rather than having to pay for the majority of their drugs and seeking reimbursement in a rather over-elaborate fashion?
The situation at present is as I have outlined to the Deputy. Of course people who are entitled to the general medical services get everything free of charge. As and from next April the remainder of the population will be able to get all their requirements free of charge subject to the £6.50 per month. I am not aware that it is all that cumbersome a scheme. As the Deputy knows, the situation is that an individual purchases his requirements and then gets a refund. If there is any way in which that refund scheme could be expedited I would certainly be glad to examine that.
Is the Minister not aware that people suffering from coeliac disease are in need of a constant special diet and consequently are involved in constant heavy and special expenditure? Would he not accept that for that reason this disease ought be included on the list of long-term illnesses which would entitle them to full consideration for the special cost involved rather than having to go through the unsatisfactory procedure of seeking refunds if they are within the eligible categories as outlined by the Minister?
I would accept that it would be better for these unfortunate sufferers if the disease were included on the list of long-term illnesses. Of course there are many diseases competing for inclusion on that list and which we are just not able at present to accommodate. The long-term illness scheme will be reviewed again before the end of this year.
Can the Minister say whether at this point there is any possibility of giving priority to two or three of these diseases which apparently cause most social as well as individual distress? I agree that a case can be made quite properly for the inclusion of all of these diseases that will be the subject of a review. I agree with Deputy Boland, and perhaps other Deputies, that the sufferers of coeliac disease and their families appear to be subject to particular pressures. Would the Minister give any indication of his view on that matter?
It is very expensive to include one of these diseases in the long-term illness scheme. There are other groups equally insistent that other particular ailments should be included. I would ask Deputies to leave the matter over for the present. I will be looking at the long-term illness scheme generally between now and the end of the year.
Has the Minister considered representations from organisations representing these people? How will that review be undertaken? Will he consider representations by Members of the Dáil in regard to hardships? What process is employed in determining the review of this scheme? Will there be a number of diseases removed from the list, or what is envisaged by the Minister?
I do not think we would be reviewing the scheme with a view to disimproving it. The normal procedure would be that the operation of the scheme would be reviewed departmentally and all representations which have been received for extensions over a period will be looked at and examined. Of course, any representations which Deputies, Senators or indeed particular organisations wish to make will be taken into account.
I am glad to hear the Minister say that he would not be reviewing the scheme with a view to its disimprovement. That seems to be out of line with the rest of his colleagues.
Is the Deputy being tendentious now?
I am sure the Minister understands perfectly what I am saying. Did the Minister say that foods can be included in the refund scheme?
Yes, they can.
All gluten-free foods?
Not all gluten-free foods, but the more important ones.
That is what I thought—and also the ingredients for making those foods—because I am sure the Minister understands that there is a limited amount of gluten-free foods available. Most parents have the problem of buying the ingredients and making them up themselves.
They have to be bought on a prescription.
Most parents do not buy them through prescripton but through ordinary retail outlets.
I accept that.
Will they be allowed to claim under the scheme?
No, only if they are regarded as medicine or drugs on prescription.
Question No. 18. The Deputy cannot stand up and put a series of questions.
I am trying to get the tail end of the Minister's reply.
May I ask the Minister a final supplementary?
The Minister is replying to Deputy Barry.
Certain foods are provided, limited to flour, bread mix, bread and baby biscuits made from wheat from which gluten has been removed. These foods can be brought into the ambit of the drugs refund scheme.
Whether they are purchased under prescription or not?
No, they must be purchased under prescription.
Is there any facility there for people who do not purchase under prescription?
I am not aware that that causes difficulty.
I can give examples. I know it causes difficulty.
However, that is something that can be looked at.
The last supplementary.
Deputy Barry is quite correct in what he is saying. These people need this food. Because coeliac disease is more common in Ireland than in any other country, would the Minister consider that, if a situation arose where the food could be bought in grocery shops, it could be purchased on the recommendations of the doctor without the patient having to pay for a prescription every time?
We are in touch fairly continuously with the organisation involved and I am not aware that that aspect is causing any great difficulty. However, if it is, we will look at it.
Question No. 18.