Dessie Ellis (Dublin North West, Sinn Fein)
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Question 18: To ask the Minister for Health if he has issued or will issue instructions in relation to medical card applications from persons who previously benefitted from the free dispensing of psychiatric medication by mental health services in the greater Dublin area and who, since the ending of this scheme, face large bills for medication and for general practitioner visits to obtain prescriptions, in some cases forcing persons to give up or consider giving up work in order to qualify for a medical card, such instructions to give special consideration to this cohort of patients; and if he will make a statement on the matter. [16266/12]

Róisín Shortall (Dublin North West, Labour)
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Under the former Eastern Health Board, it was the practice to provide psychiatric medicines free to all patients who attended an outpatient clinic for services regardless of their eligibility status. Such arrangements were unique to the greater Dublin area. In all other former Health Board Areas, similar patients were provided with psychiatric medicines in accordance with their eligibility status either through the General Medical Services Scheme or the Drug Payment Scheme.

In 2009, the HSE decided to bring the arrangements for the supply of medicines to patients attending mental health outpatient clinics in the greater Dublin area into line with those operating in the rest of the country. These changes were introduced on a phased basis, starting in October 2010 when medical card holders in the HSE Dublin North East area requiring psychiatric medicines were referred to their own GP for a GMS prescription. This arrangement was extended to the Dublin Mid Leinster area in November 2011. Drug Payment Scheme cardholders are required to pay for their prescription up to the co-payment threshold of €132 per month. Medical card holders continue to receive their medication free of charge, subject to any applicable prescription charge.

People affected by these changes who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the Health Service Executive will take into account medical costs incurred by an individual or a family, including the cost of medication. The assessment for a medical card is determined primarily by reference to the means of the applicant and his/her dependants. However, at the request of my colleague, Dr James Reilly, Minister for Health, the HSE recently set up a clinical panel to assist in the processing of applications for discretionary medical cards where there are difficult personal circumstances.

The HSE also has guidelines in place in relation to the provision of emergency medical cards to patients with a serious medical condition in need of urgent medical care that they cannot afford. Emergency medical cards are issued within 24 hours of the receipt of the required patient details and letter of confirmation of condition from a doctor or consultant. Emergency medical cards are generally requested through the manager in a Local Health Office or through a social worker.