Prior to 1971 there were inadequate provisions to provide for persons who had large medical expenses. In 1971 the long-term illness scheme was introduced, whereby patients received free drugs and medicines in respect of prescribed diseases and disabilities, regardless of income. The following conditions were prescribed in 1971: mental handicap, mental illness, for persons under 16 years only, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, diabetes mellitus, diabetes insipidus, haemophilia, cerebral palsy and epilepsy. In 1975 the following were included: multiple sclerosis, muscular dystrophies, parkinsonism and acute leukaemia.
From 1971 onwards the general medical services, medical card, scheme came into effect. 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 chief executive officer 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.
At the same time a scheme to provide for the refund of the costs of drugs above a certain threshold was introduced. Currently, non-medical card holders can avail of the drug payment scheme, which was introduced on 1 July 1999 with a threshold of £42 per individual or family unit. Under the drug payment scheme, no individual or family unit pays more than £42 per calendar month towards the costs of approved prescribed medicines. The scheme is designed to be user friendly and to significantly improve the cash flow for families and individuals incurring ongoing expenditure on medicines.
The introduction of these schemes ensured that no individual or family would be faced with undue financial hardship as a result of expenses on drugs and medicines. Consequently, the long-term illness scheme has not been extended since 1975 and there are no plans to extend it in view of the other schemes available.
