Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 548: To ask the Minister for Health if he has issued or will issue instructions on medical card applications from persons who previously benefited from the free dispensing of psychiatric medication by mental health services in the greater Dublin area and who, since the ending of this scheme, face large bills for medication and for general practitioner visits to obtain prescriptions, in some cases forcing persons to give up or consider giving up work to qualify for a medical card; if he will issue instructions to give special consideration to this cohort of patients; and if he will make a statement on the matter. [13596/12]

Róisín Shortall (Dublin North West, Labour)
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Under the former Eastern Health Board, it was the practice to provide psychiatric medicines free to all patients who attended an outpatient clinic for services regardless of their eligibility status. Such arrangements were unique to the greater Dublin area. In all other former Health Board Areas, patients used either their medical card or Drug Payment Scheme card to access psychiatric medicines.

In 2009, the HSE decided to bring the arrangements for the supply of medicines to patients attending mental health outpatient clinics in the greater Dublin area into line with those operating in the rest of the country. These changes were introduced on a phased basis, starting in October 2010 when medical card holders in the HSE Dublin North East area requiring psychiatric medicines were referred to their own GP for a GMS prescription. This arrangement was extended to the Dublin Mid Leinster area in November 2011. Drug Payment Scheme cardholders are required to pay for their prescription up to the co-payment threshold of €132 per month. Medical card holders continue to receive their medication free of charge, subject to any applicable prescription charge.

People affected by these changes who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card under the provisions of the Health Act 1970. The assessment for a medical card is determined primarily by reference to the means of the applicant and his/her dependants. In the assessment process, the Health Service Executive will take into account medical costs incurred by an individual or a family, including the cost of medication.

At the request of my colleague, Dr James Reilly, Minister for Health, the HSE recently set up a clinical panel to assist in the processing of applications for discretionary medical cards where there are difficult personal circumstances. This should be of particular benefit to persons diagnosed with mental illness whose income is in excess of the standard income guidelines. It is the Government's intention to extend free GP services to the entire population during the course of this Government.