Dáil Éireann díospóireacht -
Tuesday, 9 Nov 1999

Vol. 510 No. 3

Written Answers. - Secretin Treatment.

Michael D. Higgins

Ceist:

280 Mr. M. Higgins asked the Minister for Health and Children if he has received representations from parents of autistic children requesting the licensing of secretin; if so, if he will respond positively to these requests; the arrangements, if any, being made for its availability on a trial basis; the plans, if any, he has to address the financial burden of the parents in question by the issue of long-term illness cards, special allowances for dietary needs or medical cards; and if he will make a statement on the matter. [22645/99]

Minister for Health and Children (Mr. Cowen)

My Department has received a number of inquiries concerning secretin. Secretin is a hormone which has been used for many years as a diagnostic aid in certain gastrointestinal disorders. More recently there have been anecdotal reports from the USA of its beneficial use in children with autism. The product is not licensed by the Irish Medicines Board nor is there any application for its licensing. Any future applications received for authorisation of the product will be considered under the normal process of evaluation carried out by the board.

In view of the fact that the product is not the subject of a product authorisation from the Irish Medicines Board, it is not eligible for inclusion in the list of reimbursable items under the General Medical Services Scheme.

Secretin treatment for autism is still at the experimental stage. Clinical trials have yet to report on its efficacy and on the long-term side effects of using this treatment. Ultimately, a decision as to whether a particular treatment is introduced is a matter for clinical decision by doctors treating patients in the light of clinical trial results, experience and what is considered best practice. My Department will continue, however, to follow any progress in relation to clinical trials and research in this area.

There are a number of schemes in place at present which are designed to provide financial assistance to the parents of children with an intellectual disability and those with autism. The domiciliary care allowance, DCA, is paid by health boards in respect of children between the ages of two and 16 years who have severe physical, sensory or intellectual disabilities and who require constant care and supervision substantially greater than that which would normally be required by a child of the same age. Eligibility is subject to a means test but only the means of the child are taken into account.

The determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board. Medical cards are issued to persons who, in the opinion of the chief executive officer, are unable, without undue hardship, to provide general practitioner medical and surgical services for themselves and their dependants. Income guidelines have been drawn up by the chief executive officers to assist in the determination of a person's eligibility and these guidelines are revised annually in line with the consumer price index.

However, these guidelines are not statutorily binding and even if 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 would justify this. Medical cards may also be awarded to individual family members on this basis.

Under the long-term illness scheme, persons requiring treatment for a number of conditions, including intellectual disability, can obtain without charge drugs and medicines for the treatment of that condition. Children under 16 who are receiving treatment for conditions arising as a result of an intellectual disability are exempt for public hospital statutory charges.

Financial assistance is available towards the cost of special dietary requirements which have been prescribed and approved in certain circumstances, that is, for persons diagnosed as coeliac, those with inborn metabolic disorders or those who are chronically or terminally ill. Detailed information in relation to the dietary products for which assistance may be obtained and the circumstances under which this assistance is given is available from the various health boards.