Dáil Éireann debate -
Thursday, 27 May 1999

Vol. 505 No. 5

Written Answers. - Long-Term Illness Scheme.

Tony Gregory

Question:

76 Mr. Gregory asked the Minister for Health and Children the consideration, if any, he will give to the provision of free medical supplies to persons suffering from urostomy in view of the fact that other EU countries regard this as a lifetime illness and issue the essential supplies. [14130/99]

Minister for Health and Children (Mr. Cowen)

I presume the Deputy has in mind patients using ostomy products.

Persons with medical cards receive drugs, medicines and medical and surgical appliances without charge. Health boards may also make arrangements under the long-term illness scheme for the supply without charge of drugs, medicines and medical and surgical appliances to persons suffering from a prescribed disease or disability of a permanent or long-term nature who do not hold a medical card. There are 15 specified conditions covered under the long-term illness scheme. The scheme has not been extended since 1975 and there are no plans to change the scheme or to expand the number of conditions covered by the scheme, having regard to the fact that the needs of individuals with significant or ongoing medical expenses are met by a range of other schemes which provide assistance towards the cost of prescribed drugs and medicines, such as the drug cost subsidisation scheme and the drugs refund scheme.

With effect from 1 July 1999 these two community drugs schemes are in fact being replaced by a new scheme, the drug payment scheme, which merges the best elements of both schemes. Under the new scheme, no individual or family will have to pay more than £42 per month for approved prescribed drugs, medicines and medical and surgical appliances for use in that month. For the first time, families and individuals will be able to budget for the cost of medicines. Under the drug refund scheme, families and individuals claim reimbursement on expenditure over £90 on prescribed drugs and medicines for use in a calendar quarter. Many families and individuals have heavy expenditure on drugs and medicines in a quarter and may have to wait a further six weeks from the end of that quarter before they receive a refund, which may result in considerable cash flow problems. Under the new drug payment scheme, there is no potential for such cash flow problems. The fact that the drug payment scheme will operate on a monthly basis has other distinct advantages over the current drug refund scheme. Under the drug refund scheme, a family or an individual could, for example, in one month have expenditure of say £80 but no expenditure in the other two months. They would not have been entitled to a refund. Under the new drug payment scheme, they will only have to pay £42 in that month.

There are no qualifying criteria for inclusion in the new drug payment scheme. Where expenditure by a family or an individual exceeds £42 per month on prescribes medicines, the balance will be met by the State. This is in contrast to the old drug cost subsidisation scheme where patients had to be certified by their doctor as suffering from a condition requiring ongoing expenditure in excess of £32 per month.

The Deputy will also wish to know that, where an individual or a family is subjected to a significant level of ongoing expenditure on medical expenses due to a long-term medical condition, these expenses may be reckoned in determining eligibility for a medical card. In some cases a medical card may issue to a family member on a personal basis. Eligibility for a medical card is solely a matter for the chief executive officer of the relevant health board to decide.

I am satisfied that, in the light of the arrangements I have outlined, appropriate and comprehensive support is being provided by the State to those with ongoing medical expenses.