Dáil Éireann debate -
Thursday, 11 Nov 1999

Vol. 510 No. 5

Written Answers. - Drugs Refund Scheme.

Michael D. Higgins

Question:

17 Mr. M. Higgins asked the Minister for Health and Children if his Department has received representations on behalf of kidney patients in relation to essential items they need which are no longer included under the new drugs refund scheme; the steps, if any, he will take to deal with the hardship involved; and if he will make a statement on the matter. [22850/99]

Alan Shatter

Question:

161 Mr. Shatter asked the Minister for Health and Children if his attention has been drawn to the fact that each dialysis unit in hospitals is under severe pressure to cope with the demands of existing renal patients; if he has received recent representations from the Irish Kidney Association requesting that action be taken to address this and other difficulties, including the additional expense which renal patients must meet as a consequence of the rules applying to the drugs refund scheme; and the action, if any, he will take to address the issues in this area. [23037/99]

David Stanton

Question:

175 Mr. Stanton asked the Minister for Health and Children if he has received submissions from the Irish Kidney Association concerning the cost of ancillary medication; if so, if he will give details in this regard; the medications which had been previously available free of charge to dialysis patients and are not listed in the drugs refund scheme; and if he will make a statement on the matter. [23116/99]

Minister for Health and Children (Mr. Cowen):

I propose to take Questions Nos. 17, 64, 161 and 175 together.

My Department is aware of pressures that are being experienced and that are anticipated as a result of growing demand for renal dialysis services and has been working with service providers and other relevant organisations in assessing the overall requirements of end-stage renal failure patients. These are being considered in the context of available funding for 2000 and beyond.

In relation to the new drug payment scheme, which was introduced on 1 July 1999 with a threshold of £42 per month per individual or family unit, the primary aim is to bring about important improvements over previous schemes and the scheme is designed to be more streamlined, user friendly and to significantly improve the cash flow situation for families and individuals incurring ongoing expenditure on medicines.

In addition, people who are unable, without undue hardship, to arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. Eligibility for a medical card is solely a matter for the chief executive officer of the relevant health board to decide. In determining eligibility, the local health board will have regard to the financial circumstances and medical needs of the applicant. In this regard, income guidelines are used by health boards to assist in determining a person's eligibility. These guidelines are not statutorily binding and, even though a person's income exceeds the guidelines, the person may still be awarded a medical card if the chief executive officer considers that the person's medical needs or other circumstances would justify this. medical cards may also be issued to individual family members on this basis.

A common list of reimbursable medicines has been introduced for the GMS scheme and the new drug payment scheme. The introduction of the common medicines list ensures equity between the general medical services and the new drug payment scheme in relation to the range of medicines paid for by the State under both schemes. The comprehensive range of the most modern therapies required to treat all conditions, which was available on the GMS continues to be paid for under the new scheme. This common list is subject to ongoing review and amendment on a monthly basis as new products become available. Additions and deletions are notified on a monthly basis.

In general, over the counter products, such as vitamin supplements and cosmetic type products, are not available under the schemes. However, if a medical card holder is suffering undue hardship obtaining a medicine which is not covered under the common list, he or she may apply to the chief executive officer of the relevant health board for assistance in such instances.

Representations have been received in my Department on behalf of kidney patients concerning items not included in the common list, notably, phosphate absorbents, vitamin supplements and high factor sun screens. I am pleased to be able to inform the Deputy that with effect from 1 December 1999, calcichew, a phosphate absorbent, will be reimbursable on the common list. On foot of correspondence from the Irish Kidney Association, officials from my Department met recently with representatives from the association and explained that there are no plans to include the other products in the common list.