Vol. 411 No. 6
5 Mr. R. Bruton asked the Minister for Health whether his attention has been drawn to the fact that under the terms of the new drugs refund scheme a family may have to spend £180, without refund, on prescribed drugs necessary to deal with a bout of illness; and if he will make a statement on the matter.
39 Mr. Browne (Carlow-Kilkenny) asked the Minister for Health if he will restore the drugs refund system to the monthly basis; and if he will make a statement on the matter.
65 Mr. Gilmore asked the Minister for Health the reasons for the recent changes in the drugs refund scheme; if his attention has been drawn to the fact that under the new arrangement, a person migh have to spend up to £90 in one quarter and would still not qualify for a refund; if, in view of the hardship that this can create for many, he will review the arrangements; and if he will make a statement on the matter.
75 Mr. Pattison asked the Minister for Health if he will outline the implications of the changes in the drug refund scheme which is in operation since 1 October 1991; and if he will make a statement on the matter.
I propose taking Questions Nos. 5, 39, 65 and 75 together.
The drugs refund scheme, which provides for a refund of any expenditure on prescribed drugs and medicines in excess of a specified amount over a prescribed period, was amended with effect from 1 August 1991. Under the amended scheme the prescribed periods for expenditure are the quarterly periods commencing 1 January, 1 April, 1 July or 1 October each year. A refund will be made in respect of any expenditure in excess of £90 over the course of any of these periods.
I should emphasise to Deputies that the drugs refund scheme is one of a range of drug schemes which benefit the population as a whole. In addition to this scheme, other drug schemes, designed to meet specific needs, are in operation as follows.
The continued operation of the drug cost subsidisation scheme, which I introduced last year, ensures that persons who are certified as having a long term medical condition with a regular and ongoing requirement for drugs and medicines in excess of £32 per month are not required to pay more than £32 in any month for their drugs and medicines. They pay that amount to the pharmacist who claims the balance from the GMS (Payments) Board.
Under the medical card scheme any person who is deemed by the chief executive officer of a health board to be eligible for a medical card continues to receive all drugs, medicines and medical and surgical appliances without charge as heretofore. Over 1.2 million people, almost 35 per cent of the population, are covered in this way.
Under the long term illness scheme persons suffering from a specified long term medical illness obtain without charge drugs and medicines for the treatment of their condition.
I would point out that the changes were only introduced to the drugs refund scheme in August 1991 and, accordingly, it is too early as yet to judge their full impact. I will, of course, be closely monitoring the operations of all drug schemes to ensure that particular hardship is not caused to any individual or family. In this regard I would stress that the chief executive officer of a health board is empowered to grant a medical card on grounds of hardship.
Deputy R. Bruton rose.
Perhaps a brief supplementary.
Would the Minister not agree that this change has led effectively to a deepening of the poverty trap? How can he expect a single person on £80 or £90 a week or a married couple on £115 a week, to bear the cost of drugs, up to £180, during a bout of illness in addition to the cost of their visits to the doctor? Is it not a reality that these people will not seek medical care and will eventually be driven back to the accident and emergency departments which are already in chaos and proving very costly for the Minister? If the Minister is anxious to deal with the escalating drugs bill why does he not start with the £35 million being spent by the drugs companies in promoting the use of drugs, often in scandalous ways, among doctors across the country?
Brevity, for obvious reasons.
I do not accept the Deputy's point. Indeed, I do not understand the point he is trying to make. Under this new scheme a patient will be obliged to pay a maximum of £180 in a six month period.
For a bout of illness which will start in April and end in May.
That works out at £12 less than the amount a person who is paying £32 a month on a continuous basis will pay. As I pointed out to the Deputy, when his party were in Government a person had to pay up to £180 each month and then had to wait for up to six months before having the balance refunded to them. We did away with that and now they only have to pay £32 a month.
That is nonsense, £16 was the correct figure.
Let us get on to other questions. Question No. 6, please.
