Tuesday, 26 February 2013

Questions (729, 730, 731)

Gerald Nash


729. Deputy Gerald Nash asked the Minister for Health if he will provide in tabular form the total cost of the long term illness scheme for the years 2009 to 2012 inclusive; and the cost per patient availing of this scheme. [10279/13]

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Gerald Nash


730. Deputy Gerald Nash asked the Minister for Health if he will provide in tabular form the administration costs of the long term illness scheme for the years 2009 to 2012 inclusive. [10280/13]

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Gerald Nash


731. Deputy Gerald Nash asked the Minister for Health if he has given consideration to abolishing the long term illness scheme and giving any patient with a defined long term illness a medical card, in view of the fact that patients on the long term illness scheme already have their medication paid for and will, under the Programme for Government be in receipt of general practitioner cards; and if he will make a statement on the matter. [10281/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 729 to 731, inclusive, together.

The information requested in relation to the Long Term Illness (LTI) scheme, for the years 2009 to 2011, is set out in the following table:




Cost of the LTI scheme




Number of claimants




Cost per claimant




The figures for 2012 are not yet available.

In general, administration costs of the Primary Care Reimbursement Service (PCRS) represent less than 1% of the payments expenditure associated with all the PCRS schemes.Under the provisions of the Health Act 1970, eligibility for health services in Ireland is based primarily on residency and means.There are currently two categories of eligibility for all persons ordinarily resident in Ireland i.e. full eligibility (medical card) and limited eligibility (all others).Full eligibility is determined mainly by reference to income limits and is granted to persons who, in the opinion of the Health Service Executive, are unable to provide general practitioner, medical and surgical services to themselves and their dependents without undue hardship. There is no automatic entitlement to a medical card for persons with any specific illness.

There is a provision for discretion to grant a card in cases of "undue hardship" where the income guidelines are exceeded. The HSE set up a clinical panel to assist in the processing of applications for discretionary medical cards where there are difficult personal circumstances. There is an emergency process for a person who is terminally ill, or in urgent need of medical attention and cannot afford to pay for it, that provides a card within 24 hours while the normal application process is completed. Once a letter from the patient's GP or consultant is received stating that the person is terminally ill and the required personal details are provided, an emergency card is issued to that person for a six-month period. The Programme for Government commits to reforming the current public health system by introducing Universal Health Insurance with equal access to care for all. As part of this, the Government is committed to introducing, on a phased basis, GP care without fees within its first term of office. Primary legislation is required to give effect to Government commitment to introduce a universal GP service without fees.

Legislation to allow the Minister for Health to make regulations to extend access to GP services without fees to persons with prescribed illnesses is currently being drafted by the Office of the Attorney General and the Department and it will be published shortly. Implementation dates and application details will be announced in due course. There are no plans to abolish the LTI scheme and give medical cards to patients with defined long term illnesses.