Seanad debates

Thursday, 19 April 2018

Commencement Matters

Long-Term Illness Scheme

10:30 am

Photo of Paul CoghlanPaul Coghlan (Fine Gael)
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I welcome the Minister of State at the Department of Health, Deputy Catherine Byrne, to the House.

Photo of Maria ByrneMaria Byrne (Fine Gael)
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I appreciate that the issue I raised has been chosen as a Commencement matter.

A number of people who are suffering from rheumatoid arthritis and are taking heavy medication to deal with the pain find that their condition is not included in the long-term illness book. I wish to ascertain whether rheumatoid arthritis can be included in the long-term illness book. I also am calling for an overall review of the long-term illness book, which resulted from section 59 of the Health Act 1970. While the legislation has been slightly amended since, there has not been a great deal of change in terms of the different illnesses that have been included in it. A number of people have had to pay out a great deal of money for the prescriptions to deal with their conditions, which in some cases are long-term illnesses. It is not the case that the person will recover. A prescription from one's general practitioner, GP, to deal with the condition is not covered by the long-term illness scheme but in certain circumstances, a case can be made for a hospital prescription to be filled for a short period. It is time for a review of the long-term illness scheme. A number of illnesses and conditions should be examined in a review. I look forward to the Minister of State's response.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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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.

Photo of Paul CoghlanPaul Coghlan (Fine Gael)
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Senator Byrne might wish to ask a supplementary question.

Photo of Maria ByrneMaria Byrne (Fine Gael)
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I thank the Minister of State, Deputy Catherine Byrne. While I appreciate that the Government is committed to reducing the costs for people, especially those with long-term illness, I certainly would appreciate the Minister of State's bringing to the attention of the Minister, Deputy Harris, that there are a number of illnesses where people are on medication in the long term and perhaps a review be carried out of the LTI book. It is quite a number of years since there was a review of the ailments that are covered under the LTI scheme. It certainly is something that I meet ever more frequently. Not every illness can be included and we cannot wrap our arms around everything but certainly there are a number of ailments that should be considered for inclusion in the long-term illness book. It would be great if the Department could conduct a review of the LTI scheme.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I cannot give such a commitment. The Minister will have to decide whether there will be a review or not.

I come across this issue quite a lot as a public representative. I am aware of it from members of my own family who have rheumatoid arthritis, which affects people as they get older and can lead to very disturbing inability to be able to move around. I will convey the Senator's views to the Minister on the number of life-long illnesses that are not included in the LTI book. A review may be overdue and perhaps as part of the budgetary process we may be able to bring it to the Minister and see whether we can seek some revision and review of the long-term illness card.

I agree with the Senator that people are affected by a number of conditions that are life-long illnesses but do not come within the terms of the LTI scheme. I will bring this to the attention of the Minister for Health.

Photo of Maria ByrneMaria Byrne (Fine Gael)
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I thank the Minister of State.