Dáil Éireann Debate, Wednesday - 29 June 2016
152. Deputy Fergus O'Dowd asked the Minister for Health if he will list spinal cord injuries as long-term illnesses with an automatic entitlement to a medical card in view of representation from the Spinal Injuries Ireland panel. [18579/16]
View answerThe Long Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act, 1970 (as amended). Regulations were made in 1971, 1973 and 1975 specifying the conditions covered by the LTI Scheme, which are as follows: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. There are no plans to extend the list of conditions covered by the LTI Scheme.
Under the Drugs Payment Scheme, no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines.
Under the provisions of the Health Acts, medical cards are provided to persons who are unable, without undue hardship, to arrange health services for themselves and their dependants.
I can clarify to the Deputy that the legislation does not have a provision for the HSE to award a medical card to persons by virtue of an illness or a medical condition. However, where an applicant’s means are above the qualifying financial thresholds, the HSE routinely examines for indications of medical or social circumstances which might result in undue financial hardship in arranging medical services and, exercising discretion, may grant eligibility for a medical card on this basis.
The Deputy may be aware of the "Keane" Report of the Expert Panel on Medical Need for Medical Card Eligibility, which made a recommendation that a person’s means should remain the main qualifier for a medical card. It also recommended that it is neither feasible nor desirable to list conditions in priority order for medical card eligibility.
Following the Keane report, the Clinical Advisory Group (CAG) on medical card eligibility was established by the Director General of the HSE to provide clinical oversight and guidance to the operation of a more compassionate and trusted medical card system which can strive to ensure that the relatively small percentage of cases requiring the recognition of the burden of a medical condition(s), over and above financial hardship, can be accommodated. The Group is continuing its work on the development of guidance on assessing medical card applications involving significant medical conditions.
As a result of a range of improvements on foot of the Keane Report, the HSE is exercising greater discretion, as is evident in the increase in the number of discretionary medical cards in circulation - by about 102% - from about 52,000 in mid-2014 to 106,174 at 1 June 2016.
