Written answers

Tuesday, 23 September 2014

Department of Health

Long-Term Illness Scheme Coverage

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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364. To ask the Minister for Health if his attention has been drawn to the fact that chronic obstructive pulmonary disease is not included on the list of long term critical illness meaning that those affected are not entitled to medical cards based on medical needs; if he will reconsider the decision not to include COPD as a long term critical illness; and if he will make a statement on the matter. [35476/14]

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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The Long Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act, 1970 (as amended). Regulations were made in 1971, 1973 and 1975 specifying the conditions covered by the LTI Scheme, which are as follows: Acute Leukaemia; Mental handicap; Cerebral Palsy; Mental Illness (in a person under 16); Cystic Fibrosis; Multiple Sclerosis; Diabetes Insipidus; Muscular Dystrophies; Diabetes Mellitus; Parkinsonism; Epilepsy; Phenylketonuria; Haemophilia; Spina Bifida; Hydrocephalus; and conditions arising from the use of Thalidomide. There are no plans to extend the list of conditions covered by the LTI Scheme.

Under the Drug Payment Scheme, no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines.

Eligibility for health services in Ireland is based primarily on residency and means. The Health Act 1970 (as amended) provides for two categories of eligibility for all persons ordinarily resident in the country, i.e. full eligibility (medical card) and limited eligibility (all others). Full eligibility is determined mainly by reference to income limits and is granted to persons who, in the opinion of the Health Service Executive (HSE) are unable to provide general practitioner, medical and surgical services to persons and themselves and their dependants without undue hardship. There is a provision for discretion to grant a card in cases of "undue hardship" where the income guidelines are exceeded.

The Government decided, in consultation with the Office of the Attorney General and the Department of Public Expenditure, that the Minister for Health would revert to Government with options for providing eligibility for a range of health services on the basis of specific and defined medical conditions. The Director-General of the Health Service Executive established an Expert Panel to examine and recommend the range of medical conditions that should be considered as a basis of eligibility. The Expert Panel is chaired by Professor Frank Keane, past-president of the Royal College of Surgeons in Ireland and clinical lead of the National Clinical Programme for Surgery. The panel includes a range of 23 clinical experts from primary care, specialist services and therapies. The panel also includes a patient representative to ensure that the views of patients are central to the process. The Expert Panel is to report to the Director General of the HSE, who will then advise the Minister of the outcome of the deliberations of the Expert Panel.

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