John Gormley (Dublin South East, Green Party)
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Question 306: To ask the Minister for Health and Children the estimated cost of providing medical cards to under 18's with Downs syndrome. [12518/07]

John Gormley (Dublin South East, Green Party)
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Question 307: To ask the Minister for Health and Children the estimated cost of providing medical cards to under 18's with a recognised disability. [12519/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 306 and 307 together.

The number of persons aged under 18 and who have Down's Syndrome is not formally recorded by my Department. However it can be estimated that there are some 1,800 to 2,000 persons in this category. The number of persons aged under 18 and who are on either the National Intellectual Disability Database or the National Physical Sensory Disability Database is approximately 15,000. The Health Service Executive is not in a position to identify within its national medical card database the number of persons with full eligibility under section 45 of the Health Act 1970 who are also in either of the above categories.

It should also be noted also that under the 1970 Health Act, the Health Service Executive may arrange for the supply, without charge, of drugs, medicines and medical and surgical appliances to people with a specified condition, for the treatment of that condition, through the Long Term Illness Scheme (LTI). The LTI does not cover GP fees or hospital co-payments. The conditions include mental handicap, mental illness (for people under 16 only), phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, cerebral palsy, multiple sclerosis, muscular dystrophies, Parkinsonism and conditions arising from thalidomide.

On the basis of the average cost to the General Medical Services of general practitioner services, prescription medicines and community dental and ophthalmic services for persons aged under 18, and assuming that 70% of the persons encompassed by the Deputy's questions are not currently covered by a medical card, the estimated annual direct cost, at 2007 prices, of providing medical cards to persons under 18 with Down's syndrome is approximately €0.5 million; the estimated annual direct cost, at 2007 prices, of providing medical cards to persons under 18 with a recognised disability is approximately €3.8m.

I wish to emphasise that the above cost estimates do not take account of a range of other factors which could influence the actual cost of implementing such arrangements. These include potential requirements to pay increased fees to contracted providers if full eligibility were extended to particular categories of high-demand clients and that the actual costs of drugs, aids and appliances and other health services available free of charge to the holders of medical cards in these categories could be substantially higher than the average, given the pre-existing condition(s) of the patients concerned. They also do not take into account potential costs to the health service or other areas of Government in which the holding of a medical card may be used to determine entitlement to services or benefits.