Dáil Éireann díospóireacht -
Tuesday, 1 Dec 1998

Vol. 497 No. 5

Adjournment Debate. - Funding for Asthma Sufferers.

Mr. Timmins

I thank the Chair for giving me the opportunity to raise this important matter. It is estimated that there are 250,000 asthma sufferers in Ireland. In the one to 16 year age group, 15 per cent are asthmatics. In 1980, it was estimated that only 2.5 to 5 per cent of this group suffered from asthma. Today's 15 per cent estimate is in line with figures produced for Great Britain, Australia and New Zealand. Asthmatics are not overtly visible in society and only 2 per cent of them are members of the Asthma Society of Ireland. Until a few years ago, following the death of a school friend, I did not realise an asthma attack could result in loss of life. I do not suspect I was unique in this as the plight of asthma sufferers lay hidden for many years.

This year marks the Asthma Society's 25th anniversary. The inaugural meeting took place in the old Power's Hotel in 1973. The society at the time had a two-fold aim with regard to patient information and statutory entitlements. Following the society's continuous lobbying, the drugs cost subsidisation scheme was introduced by the then Minister for Health, Deputy O'Hanlon. While this was a welcome improvement for some, poor entitlements are every bit as much a stumbling block to better asthma control today as it was in the early years.

At least one in every seven children suffers from asthma. No one knows why the numbers are rising. One of the reasons put forward is that children spend more time indoors. Children watch television for a greater number of hours than before. There is no cure but there are several treatments which can help control the symptoms. The more one understands about the condition and its treatment, the better are one's chances of keeping it under control.

Many asthmatics are not aware of how to treat the problem and, in this respect, greater financial support is required for the Asthma Society's educational initiatives, such as the mobile asthma information unit and the asthma telephone help line. In addition, improved financial support should be made available for medical research.

Drug treatment plays a vital role in controlling the ailment. Treatment is by way of inhalers, steroid tablets where appropriate, or injections. Drug treatment is a continuous process and can prove very expensive. Fortunately, to date, asthmatics can avail of refunds for expenditure of more than £32 per month under the drug refund scheme. This pales in comparison to the position of their counterparts in Northern Ireland who enjoy free GP services, free medicines for dependent children and an annual £85 medicines bill for the rest. I fear that any drugs fund reductions may lead to many sufferers cutting back on their treatment.

Many branches of the Asthma Society do excellent work. In Arklow, County Wicklow the local branch provides year round swimming and exercise lessons at a cost of £1,500 and they provide seven nebulisers to the local Garda station for use in emergencies by the community at an annual cost of £300. All their income comes from local fundraising activities. I ask the Minister to bear in mind the needs of our asthma sufferers as he divides his very substantial budget.

Mr. Davern

I apologise on behalf of the Minister who cannot be here to reply to this matter this evening. I am pleased the Deputy raised it and gave me, on behalf of my colleague, the Minister for Health and Children, the opportunity to clarify some issues of concern to people with asthma.

In view of current reports in the media, I assume the Deputy has in mind the level of assistance available to asthma sufferers towards the costs of their drugs and medicines. Drugs and medicines for the treatment of asthma, are available to medical card holders free of charge. The present position with regard to non-medical card holders is that help with the cost of drugs and medicines is provided through the community drugs schemes. Under the drug refund scheme, which covers expenditure by the whole family, any expenditure on prescribed medicine above £90 in a calendar quarter is refunded on application to the relevant health board. There is also the drug cost subsidisation scheme, which caters for people who do not have a medical card and are certified by their doctor as having a long-term medical condition, with a regular and ongoing requirement for prescribed drugs and medicines. People who qualify for inclusion in this scheme do not have to spend more than £32 in any month on prescribed medication.

Earlier today, my colleague, the Minister for Health and Children, announced proposals for the introduction next year of a new improved scheme, the drug payment scheme, which will replace the existing drugs cost subsidisation and drug refund scheme, merge the best elements of both schemes and is designed to significantly improve the cash flow situation for families incurring ongoing expenditure on medicines. Under the new drug payment scheme, no individual or family will have to pay more than £42 per month for prescribed medicines. The balance will be met by the State.

This new scheme will have considerable benefits for asthma sufferers and their families. With the drug refund scheme, many families have heavy expenditure on drugs and medicines in a quarter and may have to wait a further six weeks from the end of that quarter while their claims are being processed before they can receive their refunds. In effect, they may have to wait up to four and a half months and incur expenditures in the next quarter before they receive their refunds. In l997 more than 110,000 claims under the drug refund scheme were for claims in excess of £150 per quarter. Of these, approximately 33,000 were for claims of £300 or more per quarter, or almost £80 per month.

This can cause considerable cashflow problems for a significant number of families. This difficulty will not arise under the new drug payment scheme. The new scheme will allow families to budget for the cost of medicines. Regardless of the size of their drugs bill, they will know they do not have to pay more than £42 in any month.

Because the drug payment scheme will operate on a monthly basis, it will have a distinct advantage over the current drug refund scheme. Under the refund scheme, a family could, for example, in one month have expenditure of, say, £80 but no expenditure in the other two months. They would not have been entitled to a refund. Under the new scheme, they will only have to pay £42 in that month.

There are also families where one member may qualify for a drug cost subsidisation scheme card but the combined expenditure on medicines by other members may be considerable. At present, this other expenditure cannot be recouped until the end of the quarter. This will change with the new drug payment scheme. Under that scheme no family will have to pay more than £42 in any month for prescribed medicines, a significant benefit for families where a few members may suffer from asthma. There are no qualifying criteria for the new drug payment scheme, unlike the current drug costs subsidisation scheme.

With regard to the increase in the threshold, I emphasise there has been no increase in the threshold for the existing schemes since 1991. It must also be borne in mind that the new threshold refers to family expenditure as opposed to the existing threshold in the drug cost subsidisation scheme which relates to individual expenditure.

I mention the work of the Asthma Society of Ireland which has done so much to increase awareness of asthma. The health promotion unit of the Department of Health and Children has had ongoing involvement with the Asthma Society and has supported the society through the provision of funding towards the costs involved in providing promotional materials and information leaflets incorporating advice of asthma.

The Dáil adjourned at 9.10 p.m. until 10.30 a.m. on Wednesday, 2 December 1998.