Fergus O'Dowd (Louth, Fine Gael)
Link to this: Individually | In context | Oireachtas source

247. To ask the Minister for Health further to Parliamentary Question Nos. 619, 620 and 621 of 25 April 2023, to provide a full update on the matter; to provide details on the discussions or engagement that have taken place within his Department and the HSE further to his statement that his Department “is currently examining all of the issues around the scope of the scheme, including this issue”; and if he will make a statement on the matter. [24476/24]

Stephen Donnelly (Wicklow, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Long-Term Illness (LTI) scheme was established under Section 59(3) of the Health Act 1970 (as amended) which provides that arrangements may be made for the supply without charge of drugs, medicines or medical and surgical appliances to persons suffering from a prescribed disease or disability of a permanent or long-term nature.

Various regulations were made in the 1970s prescribing 16 illnesses covered by the scheme. These are: 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.

The LTI Scheme has its basis in long-standing statute and is only one aspect of the overall eligibility landscape.

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 accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.

In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. The HSE afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment, including medical evidence of costs and certain expenses.

In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.

Under the Drug Payment Scheme, no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The Scheme significantly reduces the cost burden for families and individuals who are not eligible for a medical card but who have ongoing expenditure on medicines.