Vol. 515 No. 2
15 Mr. R. Bruton asked the Minister for Health and Children if he will amend the drug payment scheme as sought by the Spinal Injuries Action Association to include all items required by those with a spinal cord injury which are available to medical card holders who have suffered this injury. [5523/00]
145 Mr. Shatter asked the Minister for Health and Children if he will amend the drug payment scheme, as sought by the Spinal Injuries Action Association, to include all items required by those with a spinal cord injury which are available to medical card holders who have suffered this injury. [5614/00]
I propose to take Questions Nos. 15 and 145 together.
I think it would be helpful at the outset, by way of clarification, to provide some background to the general medical services, GMS, scheme, the drug payment scheme, DPS, and the special arrangements made by health boards for the supply of certain items to medical card holders with spinal injuries.
The position is that 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 under the GMS scheme. 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 drug payment scheme which was introduced 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. The DPS is not means tested and is available to everyone regardless of their income or financial circumstances.
A common list of reimbursable items was introduced for the GMS scheme and the DPS to ensure equity in relation to the products reimbursed by the State under both schemes. In order for a product to be included in the list of reimbursable items, it must satisfy a number of criteria, including that the product should not be advertised or promoted to the public. The list is subject to ongoing review and additions and deletions are made on a monthly basis. Health boards, however, make certain products which are not reimbursable under the common list available to medical card holders with spinal injuries through other separate arrangements. Some of these products, for example incontinence wear and dressings, are reimbursable under the DPS on a supplementary list basis.
The position with regard to urinary products is slightly different as a range of these products are included on the common list. The GMS Payments Board, on behalf of the health boards, has carried out annual reviews of the urinary products to be reimbursable on the GMS scheme on the basis of criteria published by the board and having regard to current good practice in respect of the use of these products. This list is updated and published annually. In the interests of consistency, equity and the need for good practice only those urinary products then reimbursable on the GMS scheme were, therefore, included in the common list of reimbursable items on its introduction.
However, exceptional transitional arrangements are in place with regard to the reimbursement of urinary products not included in the common list and urinary products which have been reimbursed under previous community drugs schemes continue to be reimbursed until 1 July 2000. In this regard, health boards were asked to make the necessary arrangements so that patients using urinary products which were not on the common list of reimbursable items would be assessed by the appropriate health board professional personnel, with a view to facilitating the appropriate changes in product usage. Some patients may be using older appliances and accessories not reimbursable on the GMS scheme and other patients may be using appliances which are reimbursable in association with accessories which are not reimbursable.
The Deputies will also be pleased to learn that my Department is examining arrangements for the supply to DPS patients of certain other products made available by health boards to medical card holders with spinal injuries.
Will the Minister agree, as there is supposed to be a common list between two schemes, that items available to those who suffer spinal cord injury and who qualify for a medical card should be available to those who do not qualify for a medical card under the drug payment scheme? Is the Minister aware of a letter forwarded to his Department on 6 January 2000 detailing a series of items which the health boards are now making available to those suffering spinal cord injury and who are eligible for medical cards but which do not come under the drug payments scheme? In the interests of maintaining co-ordination or symmetry between the two schemes, will he arrange that those additional items, as listed by the Spinal Injuries Action Association, be included to fall under the drug payments scheme?
I undertake to have the matter examined in light of the issue raised by the Deputy. I will communicate with him on it.
Written Answers follow Adjournment Debate.
