Vol. 524 No. 2
295 Mr. P. Carey asked the Minister for Health and Children if he will consider a proposal that recipients of the domiciliary care allowance should automatically receive the long-term illness and medical card; and if he will make a statement on the matter. [22205/00]
The long-term illness scheme entitles persons to free drugs and medicines which are prescribed in respect of a specific schedule of illnesses. The illnesses covered by this scheme are: – mental handicap, mental illness for persons under 16 years only, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, diabetes mellitus, diabetes insipidus, haemophilia, cerebral palsy, epilepsy, multiple sclerosis, muscular dystrophies, parkinsonism and acute leukaemia.
Domiciliary care allowance is paid by health boards in respect of children with a disability aged between six months and 16 years who live at home and who require care and attention considerably in excess of that normally required by a child of the same age. Many of the illnesses for which a domiciliary care allowance is in payment would also be covered by the long-term illness scheme.
People who are unable without undue hardship to arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. Eligibility for a medical card is solely a matter for the chief executive officer of the relevant health board to decide. In determining eligibility for a medical card, the chief executive officer has regard to the financial circumstances of the applicant. Income guidelines are used by health boards to assist in determining a person's eligibility. Even though a person's income exceeds the guidelines the person may still be awarded a medical card if the chief executive officer considers that the person's medical needs or other circumstances would justify this. Medical cards may also be issued to individual family members on this basis.
296 Mr. P. Carey asked the Minister for Health and Children if he will revise the regulations governing the payment of domiciliary care allowance where, instead of making all payments at a flat rate, he will introduce a system which would allow for the payment of this allowance at a basic medium and high rate depending on the level of dependency; and if he will make a statement on the matter. [22206/00]
298 Mr. P. Carey asked the Minister for Health and Children if he will modify the regulations governing the payment of domiciliary care allowance in order that, in situations where more than one person in a family is entitled to the allowance, the full rate is paid to the second or more members rather than as a proportion of the first person's payment, as applies at present; and if he will make a statement on the matter. [22208/00]
I propose to take Questions Nos. 296 and 298 together.
Domiciliary care allowance was introduced by way of Circular No. 24/73 dated 23 September 1973 and is administered by health boards on my behalf. DCA is paid in respect of eligible children under 16 years who are severely physically or mentally disabled and who require constant care and supervision at home substantially greater than that which would normally be required by a child of the same age.
As the allowance is paid in recognition of the additional care and supervision required by children who are severely physically or mentally disabled, it is not proposed to introduce a graded system of payments at this time.
With regard to the Deputy's question about the payment of a full DCA in respect of each eligible child in a family, I should point out that although Circular No. 24/73 did not make provision for the payment of a full DCA in respect of each eligible child, this was subsequently amended. Circular No. 8/78 dated 19 April 1978 stated that "the full allowance will, from 1 April 1978, be payable in respect of each eligible child irrespective of the number of eligible children in the family".
Officials from my Department have contacted all the health boards regarding this matter and have been assured that this amendment is being applied. If the Deputy is aware of an incident where the full DCA is not being paid, perhaps he would contact me and I will ask the chief executive officer of the relevant health board to investigate the case.
