Vol. 548 No. 5
220 Mr. C. Lenihan asked the Minister for Health and Children his proposals to make medical cards available in respect of sufferers of Crohn's disease and severe colitis; and if he will make a statement on the matter. [5306/02]
223 Mr. C. Lenihan asked the Minister for Health and Children his plans to extend the medical card to all people who suffer from asthma and other respiratory disorders and who will have to depend on inhaler administered drugs for the rest of their lives; and if he will make a statement on the matter. [5309/02]
243 Ms McManus asked the Minister for Health and Children his views on the inclusion of Crohn's Disease on the list of long-term illnesses; and if he will make a statement on the matter. [5381/02]
271 Mr. Shatter asked the Minister for Health and Children his proposals to make non means tested medical cards available to all children who have Crohn's disease under the long-term illness scheme; and the Government's policy in this regard. [5579/02]
286 Ms O. Mitchell asked the Minister for Health and Children if he will issue non-means tested medical cards to children who have Crohn's disease, under the Health Act 1970. [5691/02]
I propose to take Questions Nos. 220, 223, 243, 271 and 286 together.
Persons suffering from any of the following conditions, who are not already medical card holders, may obtain without charge drugs and medicines for the treatment of that condition under the long-term illness scheme: mental handicap, mental illness (for persons under 16 years only), phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, diabetes mellitus, diabetes insipidus, haemophilia, cerebral palsy, epilepsy, multiple sclerosis, muscular dystrophies, parkinsonism and acute leukaemia.
People who cannot, without undue hardship, 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 chief executive officer has regard to the applicant's financial circumstances. Health boards use income guidelines to assist in determining eligibility. However, where a person's income exceeds the guidelines, a medical card may be awarded 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. There are no plans to extend medical card eligibility automatically to include persons with asthma, Crohn's disease and severe colitis. Non-medical card holders, and people with conditions not covered under the long-term illness scheme, can use the drugs payment scheme. Under this scheme, no individual or family unit pays more than €53.33 per calendar month towards the cost of approved prescribed medicines.
221 Mr. C. Lenihan asked the Minister for Health and Children his proposals to make medical cards available in respect of children aged five years and younger; and if he will make a statement on the matter. [5307/02]
Entitlement to health services in Ireland is primarily based on means. Under the Health Act, 1970, determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board, other than for persons aged seventy years and over who are automatically eligible for a medical card. Medical cards are issued to persons who, in the opinion of the chief executive officer, are unable to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship. Income guidelines are drawn up to assist in the determination of a person's eligibility and these are revised annually in line with the consumer price index. However, the guidelines are not statutorily binding and even though a person's income exceeds the guidelines, a medical card may still be awarded if the chief executive officer considers that his/her medical needs or other circumstances would justify this. It is open to all persons to apply to the chief executive officer of the appropriate health board if they are unable to provide health services for themselves or their dependants without hardship.
The issue of eligibility was considered in the context of the new national health strategy, Quality and Fairness, A Health System For You, launched by the Government. The strategy outlines a number of measures designed to improve eligibility for health services which the Government has committed itself to introducing over a number of years. Among the measures proposed is an increase in access to medical cards. In addition to the recent extension of eligibility to all persons aged 70 years and over, the strategy includes a commitment that significant improvements will be made in the income guidelines in order to increase the number of persons on low incomes who are eligible for a medical card and to give priority to families with children and particularly children with a disability.
The strategy sets out a blueprint for ambitious and wide ranging change across the whole health system over the next seven to ten years. In setting out such a comprehensive and large-scale plan, it is inevitable that prioritising of actions must take place. The strategy represents a clear plan for moving forward which is based on a step-by-step approach to reducing inequalities in the system and building the necessary capacity to meet the growing needs of the population. Services have to be built up, waiting lists reduced, activity increased and specific groups such as children and those with disabilities require targeted service developments. I have already stated that in 2002, the Government's priorities for improving the health system will be: 709 additional acute public hospital beds and 200 beds contracted from the private sector for which €65 million is being made available; addressing waiting lists through a new treatment purchase fund for which €30 million is being made available and commencing implementation of the new model of primary care services for people with a disability and services for older people.
