Dáil Éireann Debate, Thursday - 14 December 2023
506. Deputy Róisín Shortall asked the Minister for Health if his attention has been brought to research into energy hardship experienced by cancer patients with life-limiting diagnoses (details supplied); the steps he is taking to address this issue; and if he will make a statement on the matter. [56153/23]
Amharc ar fhreagraSuccessive National Cancer Strategies have delivered continuing improvements in outcomes for Irish cancer patients in terms of earlier diagnosis, better treatment, and improved rates of survival. This Government’s commitment to implementation of the National Cancer Strategy is evidenced by significant investment in recent years. Over 2021 and 2022, €70 million in additional funding to cancer services. This included €40 million new development funding and €30 million for new cancer drugs. This investment has had a real impact on access to cancer diagnostics, treatment and supports.
Medical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.
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.
The HSE also has a compassionate system in place for the efficient provision of medical cards in response to emergency situations i.e., where persons are in need of urgent ongoing medical care or when a patient is receiving end of life treatment. In these cases, a medical card is issued within 24 hours of receipt of the required patient details and completed medical report by a healthcare professional.
In addition, since March 2021, persons who have been certified by their treating Consultant as having a prognosis of 24 months or less are now also awarded a medical card on an administrative basis. This measure delivered the Programme for Government commitment to extend eligibility for medical cards to persons with a terminal illness and work is continuing to develop a legislative framework to underpin this administrative scheme. Medical cards awarded on end of life grounds are never re-assessed by the HSE thereby providing reassurance and comfort to patients and their families.
Separately, since 2015, medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer. Further information can be found on the HSE’s website (www2.hse.ie/services/schemes-allowances/medical-cards/other-types-of-medical-card/emergency-medical-cards/)
To ensure the medical card system is responsive and sensitive to people's needs, the Department of Health keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.
In-patient charges have been abolished in all public hospitals since April 2023. The removal of these charges, was an important step towards reducing the healthcare costs of patients and families, and can save individuals up to €800 per year.
The Drug Payment Scheme (DPS) provides for the refund of the amount by which expenditure on approved prescribed medicines or medical and surgical appliances exceeds a named threshold in any calendar month. The DPS is not means tested and is available to anyone ordinarily resident in Ireland.
The DPS threshold was reduced twice in 2022:
• From €114 to €100 per month on 1 January 2022.
• From €100 to €80 per month on 1 March 2022.
Therefore, currently, under the DPS, no individual pays more than €80 a month towards the cost of approved prescribed medicines. The DPS significantly reduces the cost burden for people with ongoing expenditure on medicines.
The estimated minimum cost of reducing the DPS threshold to €72 per month is €13.2 m per annum. There are currently no plans to further reduce the threshold for the Drugs Payment Scheme.
With respect to the social welfare aspects of the Deputy's question, I note that the Deputy has asked the same question of the Minister for Social Protection who will answer on this.
