Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Senator for raising this really important issue. He is quite right in that Saoirse stole all our hearts two weeks ago on the "The Late Late Toy Show". Also, he quite rightly stated that there are so many more affected, including Darragh and Éanna. The issue can be very problematic for parents and children because the latter grow so quickly at a young age. It is an important issue and I am glad the Deputy has raised it.

The term "community-funded schemes" is a collective title for all of the many products, supports, supplies, appliances and aids that are provided through community services. A variety of products and services are provided under the schemes. The HSE provides a wide range of medical and surgical aids and appliances, such as prosthetic limbs, wheelchairs and walking aids, free of charge to medical card holders and people on the long-term illness, LTI, scheme. Assessment by a relevant health professional is required. The products and services play a key role in assisting and supporting service users to maintain everyday functioning and to remain living in their homes and local community. They also avoid the need for a hospital presentation or admission while facilitating early discharge from hospital back into the community.

Under the LTI scheme, patients receive, free of charge, drugs, medicines, and medical and surgical appliances directly related to the treatment of the diseases and disabilities covered by the scheme. People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family.

Prosthetic services are currently provided by a range of private providers, and the cost of prostheses for eligible service users is charged to the HSE. Clinical governance arrangements vary depending on the location where services are accessed. Each community healthcare organisation, CHO, operates standard processes for the allocation of funding for medical and surgical aids and appliances.In terms of eligibility criteria, each application for a prosthesis within a CHO is assessed for medical card and long-term illness card patients by the local resource allocation group. A determination is made regarding approval based on priority and funding availability within local budgets.

At times, due to the demand for resources exceeding the available capacity, waiting lists may apply for some categories of items provided through the medical and surgical aids and appliances budget in a particular CHO. CHOs undertake a range of initiatives to ensure optimum use of resources.

As part of the HSE's service improvement programme for community funded schemes, a work stream has been dedicated to standardising provision of aids and appliances at national level. This work includes the establishment of a national approved list of items, national guidance for prioritisation and standardised provision across the entire country to help ensure that the quality and equity of access to the service is improved and that what is sometimes referred to as the postcode lottery becomes a thing of the past. While the availability of sufficient resources will undoubtedly remain a challenge for individual areas in meeting demands for these services, it is expected that there will be a significant reduction in the geographical variation that has previously existed. This does not speak to the issue the Senator raised about those who do not have medical cards and who have to fundraise. I will certainly give this consideration and address it with the HSE and the Minister.