Dáil debates

Wednesday, 1 February 2017

Other Questions

Long-Term Illness Scheme Coverage

2:45 pm

Photo of Fiona O'LoughlinFiona O'Loughlin (Kildare South, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

34. To ask the Minister for Health his plans to include Crohn's disease on the list of long-term illness scheme; and if he will make a statement on the matter. [4627/17]

Photo of Fiona O'LoughlinFiona O'Loughlin (Kildare South, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

My question to the Minister concerns Crohn's disease and its first cousin, colitis, which is an incurable lifelong condition. There is a very strong case for that to be on the long-term illness list. We have one of the highest rates of these illnesses and it is growing. There are 450 young children with colitis, which is a matter of grave concern for us.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank Deputy O'Loughlin for raising this important matter. The long-term illness or LTI scheme was established under section 59(3) of the Health Act 1970 and regulations were made in 1971, 1973 and 1975 specifying the conditions covered by the LTI scheme. There are no plans to extend the list of conditions covered under the scheme. For people who are not eligible to join the LTI scheme, there are other arrangements which protect them from excessive medicine costs. Under the drug payment scheme, no individual or family pays more than €144 per month towards the cost of approved prescribed medicines. There is a commitment in the programme for Government to try to reduce that maximum monthly threshold under the drug payment scheme and it is something I would like to do in future budgets. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines. People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may also be entitled to a medical card. They Deputy is well aware of the assessment process for the discretionary medical card, which can take into account medical costs incurred by an individual or a family. Additionally, people may avail of a GP visit card, which covers the cost of GP consultations.

The LTI scheme is quite old and has not seen changes in many years. It is a scheme from the 1970s, with regulations from the early part of that decade. There are other ways in which we can try to address some of these issues. The €144 per month threshold of the drug payment scheme may be something we should look at in future budgets.

Photo of Fiona O'LoughlinFiona O'Loughlin (Kildare South, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I accept the list has not been updated since the 1970s and the Minister has clearly indicated there are no plans to review it. That is not realistic and it fails to address the changing medical needs of the population we have now. The Ireland of today is very different to the Ireland of the 1970s and I fail to understand why it should be the Government's policy not to look at changing the list.

A 36 year old lady contacted me approximately three weeks ago who had been diagnosed with Crohn's disease 15 years ago. She continued with her life, working full-time, but when she had a child ten years ago, her condition deteriorated vastly. I accept there are different levels of illness. This lady does not have a medical card despite having a long-term illness. She should be entitled to that. Her husband works all hours but they genuinely cannot afford the medical bills they have. The Minister mentioned the €144 threshold for the drug payment scheme, which is still quite an amount of money that is beyond many people.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Yes.

Photo of Fiona O'LoughlinFiona O'Loughlin (Kildare South, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

This lady's two-year illness benefit concluded in December 2016. There are many people like her. I mentioned some of the figures earlier. There are 20,000 people in the country seeing an impact, with 1,000 new cases being identified every year.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I am very much aware of the plight of people with Crohn's disease in Ireland as I suffer from the illness. I can understand how debilitating it can be to so many people in this country. I understand the financial pressures for families on low and middle incomes in meeting costs of medication. I make the point to the Deputy that in considering how we can better support people with Crohn's disease, there may be better places to look than the long-term illness scheme. This view has been adopted by successive Ministers and Governments. The scheme has been in place since the 1970s and has dealt with a number of conditions, including acute leukaemia, and terms we do not use in this country any more, such as mental handicap, cerebral palsy and mental illness. It covers a range of other issues as well, such as multiple sclerosis and cystic fibrosis.

Working together and examining the cap for the drug payment scheme, which is a commitment in the programme for Government, is one way of addressing the issue. I would be happy to meet either individuals suggested by the Deputy or representative bodies to discuss the matter further.

Photo of Fiona O'LoughlinFiona O'Loughlin (Kildare South, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank the Minister for his commitment to try to ensure that people suffering from this debilitating illness may have a better quality of life. It is very important for us to develop a national strategy to tackle Crohn's disease and colitis, as they have a devastating impact on the everyday lives of increasing numbers of people. I mentioned the 450 children in Ireland with colitis, and that represents a 90% increase in cases in children between 2002 and 2012. That is absolutely shocking. We need to have a strategy to deal with the issue.

A survey was conducted that identified the following key gaps in services to patients, which is very important. These are a lack of specialist inflammatory bowel disease nurses, lengthy waiting times for diagnostic tests and a lack of access to gastroenterology specialists and psychological services. I ask the Minister to take note of that and I wish him continued good health in dealing with the matter.

Today is Lá Fhéile Bríde and I wish a happy day to everybody.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I wish a happy St. Brigid's Day to the Deputy as well. The Deputy makes a number of very important points. This condition seems to be rising in prevalence among the population, with an impact on people at a younger age. The Deputy mentioned statistics concerning children and that huge increase is quite revealing in that regard. It is not for me to give medical advice to people but there are a number of actions people can take to help manage that condition. How we can put public information campaigns and strategies in place is something on which I would be very eager to work with the Deputy.

Some of the Deputy's points on access to diagnostics, waiting times etc. come back to how we deal with chronic disease management and whether we can do more of it in primary care. This relates somewhat to the previous schedule about empowering GPs in primary care to help look after chronic disease management. That is instead of people not finding Crohn's disease or colitis until it is nearly too late and having seen a significant flare-up. I would be very happy to engage further with the Deputy on this and meet people to see how we can put better strategies in place.

Photo of Pat GallagherPat Gallagher (Donegal, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I suggest we next take Question No. 41 in the name of Deputy O'Reilly before reverting to the others. There is only one other Member in the House with a question tabled and that is Deputy Kelleher. We can take those two questions before reverting to the others. I am sorry to inconvenience the Minister but perhaps he can find the reply to Question No. 41.

2:55 pm

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Does Deputy O'Reilly have permission to take Deputy Louise Mitchell's question?

Photo of Pat GallagherPat Gallagher (Donegal, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Yes.

Photo of Louise O'ReillyLouise O'Reilly (Dublin Fingal, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

Yes, I do have permission but I believe the Leas-Cheann Comhairle is asking if we can reverse the order of the questions. I do not mind. I am easy.

Photo of Pat GallagherPat Gallagher (Donegal, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

To be fair, there is only one other Member in the House and there are approximately five questions outstanding. We can take those two and then revert to the original order. Is that agreed?

Photo of Louise O'ReillyLouise O'Reilly (Dublin Fingal, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

Does the Leas-Cheann Comhairle want to take the next question from Deputy Kelleher?

Photo of Pat GallagherPat Gallagher (Donegal, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Does the Minister have a reply to Question No. 41 with him?

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

What is the question on?

Photo of Pat GallagherPat Gallagher (Donegal, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Question No. 41 asks about the number of elective surgeries cancelled.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Yes, I have the reply to that question.