asked the Minister for Health the proposals, if any, he has to introduce a scheme to assist asthma sufferers; in particular if he will consider assisting children under 16 with asthma by designating their condition as a long term illness; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Asthmatic Children.
6.
At present some 40 per cent of asthma patients are covered by medical cards and therefore, receive all their prescribed drugs and general practitioner services entirely free of charge. Significant on-going medical expenses are reckoned in determining eligibility for medical card cover.
Persons whose income precludes such eligibility can avail of the benefits of the drug refund scheme. This scheme ensures that their net expenditure on prescribed drugs and medicines for an individual or a family does not exceed £28 per month. Persons insured with the VHI can avail of the benefits applicable to their particular policy. Income tax relief is also available in regard to medical expenses.
It is not possible in the present extremely difficult financial situation to contemplate any extensions of the long term illness scheme, as this could be achieved only through the diversion of resources from other essential services. I am, however, reviewing the scheme with particular reference to the heavy outlay incurred in respect of some conditions including asthma to see how I can alleviate the hardship within the context of the existing drug refund scheme.
In one respect I am disappointed with the Minister's reply in view of the very extensive problem which this causes for very young children in particular. On the other hand, I am pleased that at least the Minister is departing from the previous excuses of exorbitant costs and inability to identify chronic bronchitis from asthma. Nonetheless I would, press him as to whether he would consider the introduction of a special scheme for inhaled drugs as the easiest and most cost-effective method of extending some relief, particularly to under 14 year old sufferers of this illness.
As I said, it is impossible in the current year to extend the range of illnesses covered by the long term illness scheme. I am considering whether it is possible to alleviate the hardship caused to long term illness sufferers who avail of the drug refund scheme. They have to make a high outlay of money before they receive any refund.
Under the drugs refund scheme people must first pay out money and then wait for a refund. Surely the Minister must accept that the best procedure is to introduce a special scheme so that inhaled drugs, for example, would be covered under medical card supervision.
Would the Minister confirm that as part of the effort to provide assistance to such families the £28 threshold was not increased in each of the past three years, contrary to the repeated cheap comment by Deputy McCartan? Will he agree that the retention of the £28 limit has been of benefit to families? What is the cost of extending the scheme generally and of extending it to cover those up to the age of 16 years?
Deputy Desmond is correct in saying that £28 has been the threshold for each of the past three years. It is estimated that the additional annual cost of including asthma in the long term illness scheme would be at least £10 million, possibly nearer to £20 million. The cost of the long term illness scheme in 1985 was £8.5 million. I am looking at some way of alleviating the hardship caused to asthma sufferers who have to make a considerable outlay of money for drugs and then wait for repayment. We are looking for a scheme where it would be possible to reduce the amount they would have to spend before applying for a refund. There would not be any extra cost to the Exchequer since the money is refunded any way.
How can the Minister possibly assure Deputy McCartan of sympathy under a review when the current provision as published this morning is £6.8 million for this scheme, as against an outturn for 1986 of £8.8 million? There has been a substantial reduction for the scheme.
The Deputy seems to be imparting information rather than seeking it.
In view of the fact that those who suffer from the severe forms of asthma are regularly hospitalised and will be liable from 18 May for the new hospital charges, probably at least once but possibly twice or three times a year, will the Minister consider excluding this illness, since it is not included in the lists of exclusions already published? This would be of major assistance to sufferers and would constitute the removal of a severe financial burden on those who are regularly chronically ill.
It is not possible in the current year to include asthma in the list of long term illnesses for the purpose of this scheme. As all Members appreciate, it is an illness with which we would all have sympathy and about which we would like to do something. In that context we are looking for some measure to alleviate hardship.
May I clarify a minor point?
Sorry, I want to get on to the next question. Order.