asked the Minister for Health if he will consider making medical cards available without means test to psoriasis sufferers due to the very expensive treatment needed to control the rash.

Medical cards are issued on the basis of individual financial and medical circumstances having regard to income guidelines as prescribed from time to time. The refund of drugs scheme is available to those who do not qualify for medical cards. Under the drugs refund scheme net expenditure on drugs will not exceed IR£28 per month after reimbursement by the health board.

General practitioner services and drugs prescribed for the treatment of psoriasis which are available under the general medical service are provided free of charge to medical card holders.

Where an individual medical card patient may require items not available free of charge, application may be made on hardship grounds for assistance towards their cost from the health boards.

Would the Minister not agree that the disease referred to should be on the list of long term illnesses and that a means test should not apply in such cases? I have an individual case in mind where because of the cost of the drugs involved it is not worth the man's while to work and he would be better off drawing the dole.

The case has probably already been examined by the Southern Health Board. However, medical cards are never issued on the basis of a particular condition such as psoriasis. Any expenditure he incurs in excess of £28 a month he would be fully reimbursed for by the health board. Anything over £7 a week is refundable. I do not know the individual case, but for a married couple the amount is £90.50 from 1 January. That assumes that he would not have any other allowance in excess for travelling or for rent.

Has the Minister any plans to review the list of long term illnesses with a view to adding such conditions as psoriasis mentioned here and bronchial asthma?

There are no proposals at the moment to add on additional illnesses although there is a great deal of pressure to add particular conditions such as psoriasis and asthma. It is very difficult ——

You had better keep to psoriasis.

—— to take a decision on those.

My client must get medical treatment and the drug required is on prescription, so would the Minister not agree that it should be classed as a long term illness and that the health authority should have discretionary power to make a medical card available to such clients?

I do not think it can be on an across-the-board basis. As I said, every penny that is spent over £7 a week is fully refunded. That is the position at the moment. I have been trying to keep to that £28, a month. I do not want to increase it.

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