Dáil Éireann debate -
Tuesday, 22 Apr 1997

Vol. 478 No. 1

Written Answers. - Services for the Disabled.

Mary Wallace

Question:

69 Miss M. Wallace asked the Minister for Health the services or facilities, if any, which are available from his Department for people with disabilities who do not qualify under the means test for a medical card, particularly in relation to public health nursing, incontinence pads, medication, hospitalisation, home care, nursing and personal assistance; and if he will make a statement on the matter. [10520/97]

Minister for Health (Mr. Noonan,

Limerick East): Entitlement to health services in Ireland is primarily based on means. Under the 1970 Health Act, medical cards are issued to persons who, in the opinion of the chief executive officer of the appropriate health board are unable, without undue hardship, to provide general practitioner services for themselves and their dependants.

Income guidelines are drawn up by the chief executive officers to assist in the determination of a person's eligibility and these are revised annually in line with the consumer price index. However, these guidelines are not statutorily binding and even though a person's income exceeds the guidelines, that person may still be awarded a medical card if the chief executive officer considers that his or her medical needs or other circumstances would justify this. Non-medical card holders are entitled to a board range of health services including an entitlement to public hospital and public consultant treatment subject only to modest statutory charges and out-patient services free of charges.

In the main, a wide range of community services are available free of charge to people with disabilities, including those who do not hold medical cards. These include respite care, residential accommodation, day services, home support services and provision of certain aids and appliances. The provision of public nursing services for people with disabilities who do not qualify under the means test for a medical card is a matter for health boards in the first instance. The public health nursing service aims to provide a comprehensive community nursing service for all groups, free of charge, where a nursing need has been identified and the public health nurse can seek out people in need of nursing and social care through her knowledge of local communities. When people in need of nursing care do not have a medical card they normally have to pay for home help. The supply of incontinence wear is a matter for the health boards and I understand that the boards assess applicants on an individual basis taking into account the applicant's needs and circumstances.

There are a number of schemes which provide assistance towards the cost of medication. Persons who suffer from an ongoing medical condition can avail of the drug cost subsidisation scheme which caters for people who do not have a medical card and are certified as having a medical condition with a regular and ongoing requirement for prescribed drugs and medicines. Persons who qualify for inclusion in this scheme will not have to spend more than £32 in any month on prescribed medication. Under the drugs refund scheme which covers expenditure by the whole family, any expenditure on prescribed medication above £90 in a calendar quarter is refunded by the health board.

I am satisfied that appropriate and comprehensive support is being provided by the State through the eligibility criteria currently in place and the existing range of schemes available to persons with disabilities who do not qualify for a medical card.