Written answers
Wednesday, 14 May 2025
Department of Health
Disability Services
Barry Heneghan (Dublin Bay North, Independent)
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220. To ask the Minister for Health the way in which her Department intends to respond to evidence that households with disabilities face substantial additional healthcare and medication costs; if she will expand medical card eligibility, reduce prescription charges, or provide other forms of support; and if she will make a statement on the matter. [24813/25]
Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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There are a number of affordability measures in Health that the Government has put in place to ease the financial burden being experienced by people.
Medical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.
The issue of granting medical cards on the basis of illness or a disability was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
Furthermore, since December 2018, the medical card earnings disregard for people in receipt of Disability Allowance was increased from €120 to €427 per week and applies to the assessment process for single people and to family assessments. People who are unemployed and have been on a full rate of disability payment for at least a year can retain a Medical Card for a further three years on return to work, provided they were in receipt of the payment for a period of at least 12 months prior to commencing employment.
Prescription charges were introduced in the Health (Amendment) (No. 2) Act 2010, to address the rising costs in the General Medical Services (GMS) Scheme.
On 1 November 2020, prescription charges under the GMS scheme were reduced as follows:
- For those aged over 70, €1 per item with a maximum charge of €10 per month.
- For those aged under 70, €1.50 per item with a maximum charge of €15 per month
The HSE provides a wide range of aids and appliances free of charge to eligible people following assessment by a relevant health professional. These are provided through community services known as Community Funded Schemes and play a key role in assisting and supporting people to maintain everyday functioning, and to remain living in their homes and local community. A national list, including prescribing criteria, can be found at www.hse.ie/eng/services/list/2/primarycare/community-funded-schemes/aids-and-appliances/aids-and-appliances.html
Separately, under the Long-Term Illness Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. Under the Drugs Payment Scheme (DPS) no individual pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines. In 2023, GP visit card means-tested eligibility was extended to those who earn up to the median household income, and public in-patient charges in public hospitals were abolished.
I can assure the Deputy that my Department keeps medical card issues under review in order to ensure the medical card system is responsive and sensitive to people's needs. Any changes are considered in the context of Government policy and other issues which may be relevant.
Barry Heneghan (Dublin Bay North, Independent)
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221. To ask the Minister for Health if she will increase the provision of disability aids and appliances, improve access to therapies and personal assistance services, and address existing backlogs for supports such as wheelchairs, hearing aids, and home modifications; and if she will make a statement on the matter. [24814/25]
Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Barry Heneghan (Dublin Bay North, Independent)
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222. To ask the Minister for Health to outline the interdepartmental efforts being made to develop a comprehensive strategy to address the health-related aspects of the cost of disability; if she will commit to ensuring access to medically necessary services and equipment without financial hardship; and if she will make a statement on the matter. [24815/25]
Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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The Health Service Executive (HSE) provides a wide range of medical and surgical aids and appliances free of charge to eligible people (such as those with medical cards or those on the Long-Term Illness scheme) following assessment by a relevant health professional. These are provided through community services known as Community Funded Schemes and play a key role in assisting and supporting people to maintain everyday functioning, and to remain living in their homes and local community.
The HSE provides these aids and appliances to a wide section of the community including older people, people with diverse chronic illnesses, and people with disabilities. Provision is based on an appropriate clinical assessment, the funding available within local budgets, and a determination of the most appropriate product that will meet the eligible person’s needs. Further information regarding the Community Funded Scheme can be found at:
www.hse.ie/eng/services/list/2/primarycare/community-funded-schemes/
In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE and is primarily based on an assessment of means. 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. Further information regarding medical cards can be found at:
www2.hse.ie/services/schemes-allowances/medical-cards/
The Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in the 1970s prescribing 16 conditions covered by the Scheme. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. Further information regarding the LTI Scheme, including the conditions covered, can be found at:
www2.hse.ie/services/schemes-allowances/lti/
Barry Heneghan (Dublin Bay North, Independent)
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223. To ask the Minister for Health if she will review and reinstate dedicated transport supports such as the mobility allowance and motorised transport grant; if she will outline measures to ensure that the cost of transportation does not prevent people with disabilities from accessing essential services; and if she will make a statement on the matter. [24816/25]
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