Róisín Shortall (Dublin North West, Labour)

The long-term illness scheme is a non-means tested scheme introduced in 1971. It provides free medicines and medical appliances to people with specified conditions. Some 16 conditions are covered by the scheme. Requests to expand the range of conditions are frequently made but at this point there are no plans to extend the list of conditions covered by the scheme.

People 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 can take into account medical costs incurred by an individual or a family. In recent times the situation with the assessment of applications on medical grounds has improved. There is a panel, headed by a GP, that assesses the medical applications. Those who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of general practice consultation.

Non-medical card holders and people whose illness is not covered by the long-term illness scheme can use the drug payment scheme which protects against excessive medicine costs. Under this scheme no individual or family pays more than €132 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines. In addition, non-reimbursed medical expenses can be offset against tax.

The diagnosis and management of systemic lupus erythematosus takes place in a number of health care settings. Patients with lupus are generally under the care of a rheumatologist and other specialists as necessary, such as dermatologists. The programme for Government committed to reforming the current public health system by introducing universal health insurance with equal access to care for all based on need, not on ability to pay. The universal health insurance system will be underpinned by the principle of social solidarity. Every citizen will have a choice of insurer and will have equal access to a comprehensive range of curative services.

The Government is also committed to introducing universal primary care within its first term of office. This commitment will be achieved on a phased basis to allow for the recruitment of additional doctors, nurses and other primary care professionals. A universal primary care project team has been established - we had our first meeting last week - and it has been tasked with working through the issues relating to this commitment.

While I take the points made by the Senator, it has been decided that the policy to be pursued will be in respect of providing universal free access to GP services. There is a clear commitment that we will do that within the next four years. That will cover everybody in the population. We cannot do everything, unfortunately, but we are on a clear course in terms of opening access across the population.