asked the Minister for Health if he is aware of the severe hardship which is likely to be caused to many low income families by his decision, which was announced on 1 March 1983, to increase by 43 per cent, the amount which non-medical cardholders must pay for drugs each month before being eligible for a refund; and the steps he proposes to take to ensure that the health of persons in this category is not endangered by inabilility to meet the additional costs involved.
Ceisteanna — Questions. Oral Answers. - Drug Costs.
11.
I am satisfied that the increase of £7 per month in drugs expenditure per family which will not be refunded by health boards will not cause any hardship to the vast majority of families. In the very exceptional case where undue hardship might arise it is open to patients to apply to health boards for a medical card. I am confident that such applications will receive very sympathetic consideration and that health boards will make every effort to alleviate any such hardship.
How does the Minister come to the conclusion that in the vast majority of cases the 43 per cent increase in drug charges will not cause hardship? Is it not true that of the hardship cases to which he refers only a limited number would benefit?
To my surprise the number of complaints and representations I received in relation to this scheme, which is now limited to £8 million per annum, has been exceptionally small. If hardship was imposed on any family the health board speedily responded and made every arrangement to facilitate those involved. Naturally families had to produce evidence of income. If the Deputy knows of any case where there is undue hardship, he should go to the health board and have their application reviewed. This year £8 million has been made available and so far we have been able to cope with any hardship cases brought to our attention.
Is the Minister aware that the Government's policy of refunding expenditure on drugs above a certain level to non-medical cardholders can end up costing the State more than if they had been medical cardholders and entitled to drugs free? Am I correct in saying that at the present drugs supplied free to medical cardholders are charged to the State by the pharmacist at the wholesale price, plus a dispensing fee per item, whereas the drugs supplied to non-medical cardholders are charged by the pharmacist at the wholesale price plus his mark up charge — which can be up to 100 per cent — plus a prescription charge? This makes it more expensive for the State.
This is one of the reasons why the provision over the years has been reduced from £15 million to £8 million this year. I accept the criticism implied in the Deputy's question. However, I assure the Deputy that, if he knows of any case of exceptional hardship being caused to any family in that regard, the health board will readily renew the provision. As the Deputy knows, the scheme applies to non-medical cardholders.
A final supplementary, please.
Does the Minister recall in the dying days of the last Dáil that the Labour Party proposed a Private Members' Motion calling on the then Fianna Fáil Government to review its decision——
That is pure argument, Deputy. Ceist a 12.
I have one final supplementary. Would the Minister accept that his Government removed the £5 charge at hospital outpatients' departments for non-medical cardholders at a cost of £5 million and in order to recoup this £5 million they reduced the amount available under the drugs refund scheme from £13 million to £8 million? The result of that has been to create major hardship for a number of people who are obliged every month to pay £7 extra for their drugs, whereas those using outpatients' services need only pay £5 either once or twice per annum at most.
I have been Minister for Health for only a number of months, but it has been very evident to me that all the systems are treated in a very separate and rigorous way, including the decision relating to charges in outpatients' departments. That was dealt with as an entirely separate matter. Perhaps it should not have been and perhaps there should have been some relativity. Certainly, it had no bearing on the decision relating to the refund of drugs scheme.
Would the Minister accept——
One supplementary question begets another.
It would not have been necessary if the Minister had answered my question.
It is a separate question and there is an element of argument in it.
There is no argument at all.
The Deputy is comparing one thing with another and trying to debate the subject.
Will the Minister not accept that this is creating unnecessary hardship on people who must pay £7 a month extra whereas those using hospital outpatients' services would only have to pay £5 once or twice a year?
That is a repeat of the last question.
As I said in my very first reply to this question, I was somewhat surprised that there was not more public reaction. In fact, an overwhelming majority of families have been able to cope and where any case of hardship is brought to my attention through the Department we have immediately contacted the health boards who have been very helpful and have shown considerable latitude in those areas, particularly where great hardship is likely to occur. The health boards have met all the cases of hardship.