Hardship from drug expenditure threshold
Dr. O’Hanlon argues that the £28 monthly drug-expenditure threshold causes hardship, especially after sharp increases, and questions whether health boards are being pressed to restrict services. Desmond acknowledges the cost but says spending above the threshold is refunded, patients facing undue hardship can apply for a medical card, and the scheme still meets about 220,000 claims at a cost of £6 million.
asked the Minister for Health if he is aware of the hardship caused to persons who have to pay £28.00 per month for their drugs before they receive any refund; and if he will make a statement on the matter.
Comment on this
There has been some disappointment that it was found necessary to increase the base figure to £28 but I would not accept that, in general, this has caused undue hardship. If the provision of a particular service is an undue hardship on a person it is open to him to apply for a medical card.
Comment on this
Is the Minister telling us that for a single person with £50 a week to have to pay £7 a week for his drugs would not create hardship, or that a married couple with more than £85 per week would not find hardship in having to pay £7 per week — that is £28 a month — for their drugs? Would he accept that a letter which went out from his Department on 15 December in effect asks the health boards to be more stringent in their administration of the health services to ensure that persons would not get services unless they were absolutely entitled to them?
Comment on this
Certainly I share the Deputy's view that the amount, which has been increasing gradually over the years and has increased substantially in 1981, 1982, 1983 and now 1984 to £28, is fairly considerable in terms of expenditure, but it is still only a little over £1 a day and anything over £1 a day effectively is refunded. If an individual applicant feels subjected to undue hardship in respect of the cost of drugs in excess of £1 a day for a family, it is still open to that patient to apply for a medical card. In terms of drugs provision I have not heard of any notable stringency being implemented on the part of the health boards in that regard or in any exceptions to it.
Comment on this
The Minister says that the amount for drug refund has gone up over the last three years. Would he agree that when he came into office the figure was £16 and 18 months ago the figure was only £12?
Comment on this
It has been the practice to increase the amount in every budget, generally speaking. Almost every budget has increased the amount, and the Deputy's party in Government were no exception. It is now at £1 a day and the cost to the State still this year is around £6 million and we are still catering for about 220,000 claims.
Comment on this
The purpose of the question is to try to get the Minister to recognise that £28 per month, £1 a day, £7 a week, is creating hardship.
Comment on this
It might take a long time to do that and Question Time would not be appropriate for it.
Comment on this
——it went up by £4 from £12 to £16, not by £12 as it has done in 14 months under the present Minister. It went up by £4. Now it has gone up by £12 and this is what is causing the hardship.
Comment on this
I stress that in percentage terms from £12 to £16 was no more or less rigorous in percentage terms than from £23 to £28 in 1984. If we want to score points, from £23 to £28 probably would be less of an imposition. A fact of life is that still £6 million is being spent this year on such refunds and 220,000 claims are being met for people with expenditure in excess of £28. Again I stress that 40 per cent of the population have medical cards. If we are talking about the other 60 per cent outside of that, whereas unquestionably there are problems for some families such as those in the poverty trap just outside the medical card guideline, nevertheless the cost is £6 million a year.