Dáil Éireann Debate, Wednesday - 29 June 2022
178. Deputy Pauline Tully asked the Minister for Health if prosthetic patients are automatically entitled to a medical card, general practitioner card or long-term illness card; and if he will make a statement on the matter. [34670/22]
Amharc ar fhreagraThe HSE provides a wide range of medical and surgical aids and appliances, including prosthetics, free of charge to eligible persons (such as medical card holders and people on the Long-Term Illness scheme) following assessment by a relevant health professional. These are provided through community services known as Community Funded Schemes and play a key role in assisting and supporting people to maintain everyday functioning, and to remain living in their homes and local community.
Amputees, whose amputation arose from either a traumatic or elective event, usually have their primary prosthesis fitted at the hospital where the surgery was undertaken. Subsequent prostheses are provided to eligible patients through the Community Funded Schemes. Rehabilitation services are provided by the National Rehabilitation Hospital primarily at their site in Dun Laoghaire and augmented by a number of satellite clinics that they operate throughout the country. There are also a number of smaller services operated at regional level that provide assessment and fitting clinics along with prostheses at a local level.
The 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, prescribing 16 illnesses covered by the scheme. These are: 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.
Under the LTI scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. . All persons 'ordinarily resident’ in the Republic of Ireland who are diagnosed with at least one of the listed illnesses are entitled to apply. There is no means test for the LTI scheme.
Under the Health Act 1970, eligibility for a medical card is based primarily on means. The Act obliges the HSE to assess whether a person is unable, without undue hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure.
The issue of granting medical or GP visit cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
