Dáil Éireann debate -
Thursday, 11 Nov 1999

Vol. 510 No. 5

Written Answers. - Asthmatic Patients.

Michael Finucane

Question:

60 Mr. Finucane asked the Minister for Health and Children the comparative costing, if any, undertaken by his Department on the cost of medication provided for asthmatic patients being paid for through the drugs payment scheme as opposed to all asthmatics being brought under the long-term illness scheme; and his views on whether applying the long-term illness scheme to asthmatics would result in better care and more efficient taking of medicines by asthmatics and a consequent reduction in in-patient hospital admissions. [22803/99]

Alan Shatter

Question:

158 Mr. Shatter asked the Minister for Health and Children the comparative costing, if any, undertaken by his Department on the cost of medication provided for asthmatic patients being paid for through the drugs payment scheme as opposed to all asthmatics being brought under the long-term illness scheme; and if applying the long-term illness scheme to asthmatics would result in better care and more efficient taking of medicines by asthmatics and a consequent reduction in in-patient hospital admissions. [23034/99]

Minister for Health and Children (Mr. Cowen):

I propose to take Questions Nos. 60 and 158 together.

It is not possible to provide a cost for the inclusion of asthma in the long-term illness scheme as figures are not available on the number of people suffering from asthma in this country. Figures available from the General Medical Services (Payments) Board in regard to asthma medication for 1998 under the old drug cost subsidisation scheme show a cost in excess of £10 million. However, this scheme was provided in conjunction with the old drugs refund scheme, which was operated by the health boards and was based on family expenditure on drugs rather than on individual expenditure or specific illnesses. Definitive information on the cost of asthma medication under that scheme is not available on the drugs refund scheme. In relation to data on asthma drugs, it should also be noted that asthma is not necessarily the only diagnosis and other conditions could include bronchitis and emphysema.

The list of illnesses covered by the long-term illness scheme has not been extended since 1975 and there are no plans to extend the scheme, having regard to the other schemes available to help people with the cost of drugs and medicines. For example, 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 for a medical card, the local health board has regard to the financial circumstances of the applicant. Income guidelines are used by health boards to assist in determining a person's eligibility. However, 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.

Non-medical card holders can avail of the drugs payment scheme, which was introduced on 1 July 1999 with a threshold of £42 per individual or family unit. The primary aim of the new scheme is to bring about improvements over previous schemes and it is designed to be user friendly and to significantly improve the cash flow for families and individuals incurring ongoing expenditure on medicines.

I am not aware of any systematic evidence that would support the view that better care and more efficient taking of medicines might ensue if asthma was included under the long-term illness scheme.