asked the Minister for Health if he will include drugs for bronchial asthma in the list of drugs available under the long-term illness scheme for children under 16 years.
14.
Ceisteanna—Questions. Oral Answers. - Bronchial Asthma Drugs.
13.
asked the Minister for Health the estimated cost of making prescribed inhaled drugs or their oral equivalents available free of charge at chemist shops for those who are not holders of medical cards and who suffer from bronchial asthma.
I propose to take Questions Nos. 13 and 14 together.
The inclusion of asthma in the prescribed list of conditions covered by the long-term illness scheme is under constant review in my Department. This would provide drugs free of charge to children and adults not covered by medical cards. It is estimated that there are some 60,000 persons in this category. Because their needs very considerably, it is impossible to give an accurate statement of cost.
At present persons whose expenditure on a month's supply of medicine exceeds £23 may recover the balance over that amount from the health boards. If only a quarter of asthma patients regularly expend that amount, the yearly cost of supplying them would exceed £4 million. The cost of supplying the others could be of the order of £3 millions, giving a total estimated cost of £7 million. Unfortunately, the present financial circumstances do not permit the expansion of the scheme on that scale.
The Minister has stated that the inclusion of asthma in the prescribed list of conditions covered by the long-term illness scheme is under constant review in his Department. When is he likely to make a decision on allowing this to be categorised as a long-term illness? I have no doubt he is aware that many children under 16 years of age have very severe bronchial asthma which, without wanting to sound alarmist, can be a life-threatening illness. It is essential for them to have the necessary medications available but many cannot afford them because of the very high cost of these preparations.
The question of including asthma in the list of prescribed illnesses is regularly before us. As the Deputy is aware, asthma is probably the major condition which is not covered by the scheme. Lest the Deputy should be under any illusions, however, the cost involved is considerable and I do not have any money — nor am I likely to have any in 1984 — for extending the scheme. A very large number of people suffer from asthma and the cost of catering for it would be very considerable.
When was the last addition made to the list of prescribed illnesses? The average cost of medication for one asthmatic child, without any complications, is between £20 and £30 a month for inhalers, etc. This falls just under the limit beyond which one can apply for refunds so that the family——
A question, please.
——who are caught with that regular expense have no leeway if they are slightly over the limit. Would the Minister see what can be done for low income families under the special hardship provisions in the Department to give some relief to families who are marginally over the limit?
The position is that 39 per cent of the population are covered by medical cards. I would have great difficulty on the basis of existing resources available to me in including asthma and its associated illness, bronchitis, in the scheme. It will certainly not be this year and it is most unlikely to be next year either.
In view of the seriousness of bronchial asthma, which has killed many people, will the Minister allow more flexibility to members of health boards to exercise their discretion in allowing medical cards to be supplied to patients under special circumstances? These special circumstances forms are sent to many applicants for medical cards and are filled in appropriately by patients and their doctors but it seems to take a long time before any response is obtained from the board.
That seems to be a different question, Deputy.
I was trying to help the Minister. Undoubtedly those who are just over the medical card income limit, the lower middle class, are the new poor.
There has been a major review of the situation in regard to eligibility criteria, the result of which was presented to us recently. It was because of Deputies Mac Giolla and De Rossa having raised the question of major regional disparities in eligibility criteria that I decided to have that review undertaken.
All my patients have got forms from the Department.
There is considerable leeway available to the health boards in respect of granting medical cards in exceptional cases. I have known the boards to be quite generous, so much so that nearly four out of every ten people now have medical cards. This represents an increase of from 35 to 38 per cent.
We must not spend any more time on this question. There are Deputies who have been sitting here all during Question Time but whose questions have not been reached.
The Minister knows that the people who have medical cards are entitled to them.
We are not talking about medical cards now. I am calling Question No. 15. It is most unfair to other Deputies that a few should hog Question Time.
I do not think you can include me among those who hog Question Time.
That is so, but the Deputy is capable of asking a very long question when she is called.
Can the Minister say when was the last occasion on which there was an addition to the prescribed list and, if so, what was the illness involved?
I will communicate with the Deputy on the matter. There is a large number of illnesses covered.
Because of the prevalence of bronchial asthma, I am asking the Minister to have it included.