Catherine Byrne (Dublin South Central, Fine Gael) | Oireachtas source

The Minister for Health, Deputy Harris is in the Dáil taking questions on health. The Minister apologises to the Senator for his absence but I will deal with the issue on his behalf.

I thank Senator Byrne for raising this matter in the Seanad. The long-term illness, LTI, scheme was established under section 59(3) of the Health Act 1970, as amended. The conditions covered under the LTI scheme were prescribed in subsequent regulations and are listed as follows: acute leukaemia; mental handicap; cerebral palsy, mental illness, in a person aged under 16 years, cystic fibrosis; multiple sclerosis; diabetes insipidus, diabetes mellitus; muscular dystrophies, parkinsonism, epilepsy, phenylketonuria, haemophilia, spina bifida hydrocephalus and conditions arising from the use of Thalidomide drug.

Under the LTI scheme, patients receive free of charge, drugs, medicines and medical and surgical appliances which are used directly for the treatment of their illness. While the Minister appreciates that rheumatoid arthritis is a life-long condition, there are no plans to extend the list of conditions covered by this scheme. For people who are ineligible for the long-term illness scheme, there are other arrangements that cover excessive medical costs. I refer to the General Medical Services, GMS, scheme, the medical card, the GP visit card and the drugs payment 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 HSE can then take into account medical costs incurred by an individual or families. The scheme is independent of the LTI scheme. People who are not eligible for the medical card may still be able to avail of a GP visit card, which covers the cost of the GP consultation. The scheme is available to all those aged under six years or over 70 years. However, access is based on income. The income threshold is higher than for the medical card and various costs may be taken into account in determining the eligibility for this service. Someone who has neither a medical card nor a GP visit card can use the drugs payment scheme, DPS, which limits the expenditure on prescription items. Under the DPS, no individual or family pays more than €134 a month towards the cost of approved prescription items. This threshold was reduced from €144 at the start of 2018. The DPS significantly reduces the cost for families and individuals with ongoing medical needs. The Government is committed in the programme for a partnership Government to reduce the cost of medicines for all citizens. It has already been addressed through a range of measures, including significant price reductions and greater use of reference pricing and generic substitutions. The further reduction in the DPS threshold and in the prescription charges for medical card holders will be considered in the context of the health commitments in the programme for Government and having regard to the funding available.