GP visit card for people with long term illness

curlymo

It was promised in the budget in December that people with long term illnesses would receive the GP visit card in March. Checked it out on Friday with the Department of Health and said that it would be late summer before they would be issued as they have to be legislated on first. If it was a tax that the government was taking off the people it would have been implemented on the 1st day. But as usual promises don't come when promised by the our Government.

elvis jones

curlymo wrote: »

It was promised in the budget in December that people with long term illnesses would receive the GP visit card in March. Checked it out on Friday with the Department of Health and said that it would be late summer before they would be issued as they have to be legislated on first. If it was a tax that the government was taking off the people it would have been implemented on the 1st day. But as usual promises don't come when promised by the our Government.

You're not wrong there.

bravo

In the same boat....waiting!
Sent another email to the Ministers Office today asking the same question - When?
Last answer was ..."by the summer".

sobaga

This "by the summer" thing will happen just the way the Compliance Bill did - it was deferred and deferred, re-read, amended, read again and... scrapped. I don't believe in a free GP care in this country, thank God that LTI is there - with the prices of medicines here I would be probably dead already

5live

I think they did a cost/benefit analysis and found it would be cheaper to have people seen and treated early in the community rather than requiring later more expensive interventions and taking up ward spaces.

Maybe i have had a bout late onset optimism but i can see it coming in later in the year

echo beach

5live wrote: »

I think they did a cost/benefit analysis and found it would be cheaper to have people seen and treated early in the community rather than requiring later more expensive interventions and taking up ward spaces.

I wonder how much they spent to come to that fairly obvious conclusion.

The problem is that although treating people in the community may be cheaper you have to spend now to save later and you have to move the money from one part of the health budget (hospitals) to another part (primary care) when a lot of vested interests want to keep it where it is.

uli84

:mad:
http://www.independent.ie/national-news/doctors-want-more-money-to-provide-free-treatment-for-longterm-patients-3080834.html

sobaga

Oh this is just sickening! The medics in this country (and probably everywhere else) are so greedy! My GP charges like 50 quid per visit (if he only gives you a prescription and possibly listens to your chest, otherwise it's more) and he sees between 20 and 30 patients a day in his surgery. No secretary or nurse, he obviously does not need them I would love to be on whatever he earns per day, paid to me a week! Or even a fortnight! If I have GP visit card, he will get the money he would be getting from me anyway, just the source would be different. But because this is the government who's going to pay them, they see an opportunity for themselves to milk more out of the scheme :mad:

MarthaMyDear

I wonder how you qualify for a visit card? Can it be any long term illness? I am in and out of the GP for both endometriosis and otitis externa so I wonder will I have any luck applying when they finally come out!!

Redmal

MarthaMyDear wrote: »

I wonder how you qualify for a visit card? Can it be any long term illness? I am in and out of the GP for both endometriosis and otitis externa so I wonder will I have any luck applying when they finally come out!!

Have you ever applied? It's the same process as applying for a Medical Card. Long term illness is a factor depending on what it is and if it is genuine, but it is also means tested at the moment, not sure if that will change with regards to people with long term illnesses. Sometimes people will get their GP to write a letter of support on their behalf confirming their illnesses and medications and that they feel that the patient would benefit from obtaining a Medical Card or a Doctor Visit Card. Sometimes these can help. Anyone who asks me about applying, I always tell them to just apply, worst they'll get told is that they are not entitled to one. You never know, you might get lucky

graflynn

MarthaMyDear wrote: »

I wonder how you qualify for a visit card? Can it be any long term illness?

This information is from the HSE website. http://www.hse.ie/eng/services/Find_a_Service/entitlements/Long_Term_Illness/

If you have any of the illnesses listed below you qualify for this scheme regardless of income.

What is the Long Term Illness Scheme?
If you have certain long-term illnesses or disabilities, you may apply to join the Long Term Illness Scheme and you will be supplied with a Long Term Illness book. This book allows you to get drugs, medicines, and medical and surgical appliances directly related to the treatment of your illness, free of charge. It does not depend on your income or other circumstances
and is separate from the Medical Card Scheme and the GP Visit Card Scheme.

If you already have been given a Medical Card, you do not need to apply for a Long Term Illness book. If you become ineligible for a Medical Card at any stage, but have one of the medical conditions below, you should apply to join the Long Term Illness scheme to cover the cost of your medication.

• 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
• Conditions arising from the use of Thalidomide

back to top
How do I Qualify?
You must be ordinarily resident in Ireland and hold a PPSN. You qualify if you have one of the illnesses or disabilities listed below:
There is no income requirement or means test. If you have a medical condition that is not listed above, you should consider applying for a Medical Card or a GP Visit Card.

Redmal

That information is for application of a Long Term Illness book, not a GP visit or Medical card. The Long Term Illness book means that you don't pay for any medication relating to your particular long term illness but you still pay for doctors visits and other medications you may require that aren't related to your illness. It's still good information though, I never knew these existed until my GP surgery and chemist actually sorted it out for me!

MarthaMyDear

Thanks for the replies, I've never applied but maybe I will! So expensive having to go in and out to the doctor all the time!

greenbicycle

Good news!

Looks like our GP visit cards are on the way this summer.....


http://www.thejournal.ie/phased-introduction-of-free-gp-care-announced-429156-Apr2012/

Eurovisionmad

Is it only a GP Visit card or is it a full Medical Card, 'cause I went to my GP today and he kept on saying I'd get a medical card!

greenbicycle

I think its just a GP visit card..........

Spook_ie

Its for a free GP Visit Card, not full Medical Card

echo beach

greenbicycle wrote: »

Good news!

Looks like our GP visit cards are on the way this summer.....


http://www.thejournal.ie/phased-introduction-of-free-gp-care-announced-429156-Apr2012/

Don't hold your breath. What this leglislation will do is ALLOW the introduction of free GP care. It won't make it happen. The next step after that will involve spending money as the GPs will have to be paid for providing the care. Given that this first step is already far behind schedule you can expect further delays before anything acually happens.

bravo

So the primary legislation is to be enacted by the summer?
Its almost July and nothing has moved on this issue to my knowledge...and I'd love to be corrected on this.
I could do with this card for a combination of medical problems including diabetes t2.
So more empty promises, and my GP is still getting my money which I can ill afford to give him, and of course I don't qualify for a medical card or GP visit card as things stand.

The_Conductor

bravo wrote: »

So the primary legislation is to be enacted by the summer?
Its almost July and nothing has moved on this issue to my knowledge...and I'd love to be corrected on this.
I could do with this card for a combination of medical problems including diabetes t2.
So more empty promises, and my GP is still getting my money which I can ill afford to give him, and of course I don't qualify for a medical card or GP visit card as things stand.

The heads of the bill have been published- nothing more, nothing less.
It will likely be at least the Autumn before this comes up on the agenda unfortunately.
Heres hoping the current list of long term illnesses isn't used as a template for the card........

echo beach

smccarrick wrote: »

Heres hoping the current list of long term illnesses isn't used as a template for the card........

That is exactly the intention. The figures have all been calculated on EXISTING holders of Long Term Illness cards (green books). I'm sorry to say that if you don't have one you certainly won't be in the first group getting free GP care.

The_Conductor

echo beach wrote: »

That is exactly the intention. The figures have all been calculated on EXISTING holders of Long Term Illness cards (green books). I'm sorry to say that if you don't have one you certainly won't be in the first group getting free GP care.

Dammit......

The list of conditions covered is highly arbitrary- there are more debilitating conditions out there- as indeed there are conditions with far higher 5 year fatality rates- than some on the list. Its really not fair to use the current list- drawing a line in the sand- and covering some folk with serious medical conditions, but not others.

I accept that in the current climate- there isn't money to spend on schemes- however- there is at least as valid and legitimate an argument to put forward on behalf of some chronic illnesses and diseases, as there are for many of the covered ones........ :(:(:(:(:(

echo beach

smccarrick wrote: »

Dammit......

The list of conditions covered is highly arbitrary- there are more debilitating conditions out there- as indeed there are conditions with far higher 5 year fatality rates- than some on the list. Its really not fair to use the current list-

I agree. The listing is completely arbitary. The scheme started in the fifies or sixties as the 'diabetic scheme' and just covered diabetics. Over the years other diseases were included just because somebody made a good case for them at the time. In the seventies it was decided that this approach wasn't fair and they decided to review the scheme before any new illnesses would be included. This 'review' is going on since, as anybody that has tried to have 'their' illness included has been told. It is at least thirty years since the list has been revised although asthma and glaucoma, among many others, have made convincing cases.

Basically the choice was cover all chronic illnesses or none. Covering them all was too expensive and no politician had the nerve to end the scheme so we have a situation where it is a roll of the dice if you get the 'right' illness.
Multi-millionaires get their insulin free while those a few euro over the limit for a medical card have to struggle to buy inhalers so their children can breathe comfortably.
There is nothing fair about our health system but this is one of the most unjust parts of it and it seems the intention is to carry this injustice into the new free GP care scheme. It doesn't fill me with confidence that we will live to see a fair and equitable system for all.

uli84

Soooo...it's not happening, is it?

echo beach

uli84 wrote: »

Soooo...it's not happening, is it?

No it's not, and now it's official that it's not.

I notice it was a junior minister who got the job of breaking the bad news, and trying to spin it that not delivering something they repeatedly promised isn't breaking a promise.
Reilly must have been so busy yesterday he couldn't tell us himself.

ANXIOUS

Link?

The_Conductor

ANXIOUS wrote: »

Link?

From the Irish Times

The Government is set to abandon a key election commitment to extend free GP care to almost 60,000 people with long-term illnesses.

The plan, proposed as a first step on the way to free GP care for all, was supposed to have been introduced by March 2012. However, legal difficulties delayed its introduction and Ministers now accept there is no prospect of its implementation this year.

Instead, the Department of Health is looking at alternative ways of phasing in the government’s proposals for free GP care for all. One option being examined by Minister of State for Primary Care, Alex White, would be to phase it in over a number of years by extending the scheme gradually to people in specific age categories.

Another option being considered is the progressive application of a subsidy over a number of years to offset the cost of a medical card until such time as free care is introduced.

Because of the delay in introducing the first phase, it is looking increasingly unlikely that the broader commitment in the programme for Government to implement free GP care for all will be achieved as promised in the lifetime of the current administration.

Nor is there any indication where the €400 million-€450 million a year needed to fund the plan will come from.

Alarmed at this drift in a key Government commitment, the Cabinet’s health subcommittee recently considered how to get the phased introduction of free GP care back on track. Ministers were told it would take at least another eight to 10 months to introduce the legislation that would allow for the provision of GP cards to people with long-term illnesses.

While this target has been abandoned, Mr White has been instructed to research other options. Sources say the committee favours recasting the promise to ensure sufficient progress is made in the second half of the Government’s term.

“If people see we’re a good way down the road, I think they’ll accept that free GP care is on the way,” said one Minister.

At present, people with specified long-term illnesses get their drugs free but have to pay to see a GP.

Commitment
The programme for Government contains a commitment to introduce free primary care for people with long-term illnesses within the first year.

However, this deadline was missed as was a second deadline to extend the scheme further to people on the High-Tech drugs scheme.

No legislation has been published despite repeated promises that its introduction was imminent.

The plan ran into difficulties in the Attorney General’s office, where the legal advice was that granting medical cards on the basis of medical needs rather than income could be open to challenge.

Because the existing Long Term Illness scheme is regarded as legally frail, the Attorney General advised against using it as the basis for extending the availability of free primary care. The €15 million allocated for this purpose last year was spent on offsetting the HSE’s deficit.

Asked yesterday about its plans, the department said legislation was being drafted for the first phase of free GP care, but its statement made no specific reference to the proposal to provide medical cards for people on long-term illness. “The legislation will be published when it is completed,” it said.

uli84

So disappointing it looked quite real until recently...

The_Conductor

uli84 wrote: »

So disappointing it looked quite real until recently...

It sounds like they're squirming- they are going to implement it- just not in a given timeframe (and from comments- probably not in this Dail). It will be interesting to see whether they tackle all long-term illnesses with this- and not the arbitrary list as was originally proposed (and which they deemed unworkable). The pricetag of 400-500 million for this (however they're coming up with this figure) is a major incentive for the government to put this on the long finger.

echo beach

You can't have free GP care without GPs, so if you were serious about it the first thing to do would be to talk to the GPs. So far they haven't which is why I'm not convinced that this government is serious about the plan.
It has never been clear, or not to me anyway, how it will tie in with Universal Health Insurance, UHI, or if it is independent of it. It all comes back to money. 'Free' care isn't free. Somebody has to pay for it and until we know who will be doing the paying and how much they will have to pay there can't be any progress.

Eurovisionmad

echo beach wrote: »

You can't have free GP care without GPs, so if you were serious about it the first thing to do would be to talk to the GPs.

I contest that, the free GP care in NHS was brought in at the time to almost unanimous opposition from GPs and of course the government at the time were burdened by massive war debt and austerity but the political will was there to do it, something distinctly lacking today. Regardless in many ways free GP care can pay itself back by being a preventative measure and avoiding the need for costly hospital care latter on. I've a feeling more than anything else that James Reilly is behind the policy being thrown out, the GPs perceive that they'll lose money because of this and of course Reilly is an IMO head through and through!

The_Conductor

They won't necessarily save money- a lot of people are avoiding going to the GP now- because they can't afford it, whereas if it were free, they'd be a lot more inclined to use it. Further- with the way litigation has gone in the country- GPs might order whole rafts of tests, just to cover themselves- akin to what happens in the States. Also- by moving people, many of whom are managing to hold down a job and pay their way, somehow, onto a free scheme- you have a new cohort of people using the system, who previously would have had to pay for visit/prescriptions themselves.

There definitely is a cost associated with the project- it may allow those of us afflicted with longterm illness the luxury of visiting a GP without having to worry about the bill- where now we soldier on, without medical care. Visiting a GP is very much a luxury these days- something the politicians don't seem to appreciate.

echo beach

Eurovisionmad wrote: »

I contest that, the free GP care in NHS was brought in at the time to almost unanimous opposition from GPs and of course the government at the time were burdened by massive war debt and austerity but the political will was there to do it, something distinctly lacking today.

That is a good point and one I'd forgotten but the world, and medicine, has changed beyond recognition in the 60 odd years since the NHS was founded. It was thought then that as the population became healthier costs would decrease. In fact they have escalated with advances in treatment, ageing populations and the increase in conditions like diabetes and obesity related problems.
The lack of political will, and political leadership, is certainly the main problem. There is nobody with a vision of where healthcare should be going and any number of vested interests who want to maintain an unsustainable status quo and drive care away from local communities and into vast buildings that are 'centres of excellence' in name only.

Regardless in many ways free GP care can pay itself back by being a preventative measure and avoiding the need for costly hospital care latter on.

That should be the case but in practice it isn't. GPs refer patients to hospitals for more tests and more hi tech expensive procedures. Even if there were savings in the long run, which I doubt, that is no good to politicians who want to see short term gains. That is why the budget for preventative medicine and health promotion is tiny.

jwwb

For the day that's in it with the launch of free GP care for under 6s.

Who remembers this little announcement that came to naught.

It will be on my list come election time.

The_Conductor

jwwb wrote: »

For the day that's in it with the launch of free GP care for under 6s.

Who remembers this little announcement that came to naught.

It will be on my list come election time.

I had the following response to a query I made (2 years ago):

"I have forwarded your correspondence to the Minister for consideration. The Minister has indicated that Ulcerative Colitis and Crohn's Disease are not recognised as Long Term Illnesses" (the end).

Its definitely something we need to hassle politicians about.

echo beach

it has been a frustrating morning for those trying to register their children for the under-sixes scheme. The relevant page on the HSE website won't load. May be a signal of what is to come with increasing chaos in overloaded GP services.

locum-motion

The_Conductor wrote: »

I had the following response to a query I made (2 years ago):

"I have forwarded your correspondence to the Minister for consideration. The Minister has indicated that Ulcerative Colitis and Crohn's Disease are not recognised as Long Term Illnesses" (the end).

Its definitely something we need to hassle politicians about.

What relevance does your comment have to the comment you replied to?

The_Conductor

locum-motion wrote: »

What relevance does your comment have to the comment you replied to?

Jwwb asked who remembered the announcement of a GP visitation card for those with Long Term Illnesses. It was to be rolled out to all of those with long term illnesses- not just those covered under the pre-existing LTI scheme- as "The list of stated conditions is being abandoned 'as the legal framework for defining illnesses under the scheme is considered to be legally frail'." We (various members of the LTI forum- and also the 2 Yahoo groups) mailed the minister (back in 2013) and were told at the time that conditions we mailed about (I mailed about Crohns and Colitis- other wrote about other conditions) were not recognised as long term illnesses (nothing more was said to any of us- they were one paragraph letters).

The press release- said the DPS scheme would progressively be used as a tool to roll out free GP care- and it would be tackled by age group- over a number of years.

Then nothing, at all, happened.

Its dead in the water.

We all need to make our politicians aware- that we haven't gone away- and we deserve to be treated in a fair manner.

locum-motion

There was NO WAY that the GP Visit Cards were EVER going to be given to anyone with any long-term illness (note: lack of capitals) other than the ones already on the Long Term Illness Scheme (note: capitals).

Campaigning to have your own particular long-term illness included in the LTI scheme is an entirely different subject to this thread.

Kristopherus

locum-motion wrote: »

There was NO WAY that the GP Visit Cards were EVER going to be given to anyone with any long-term illness (note: lack of capitals) other than the ones already on the Long Term Illness Scheme (note: capitals).

Campaigning to have your own particular long-term illness included in the LTI scheme is an entirely different subject to this thread.

Does the LTI Card not cover all medical expenses of the holder?

echo beach

Kristopherus wrote: »

Does the LTI Card not cover all medical expenses of the holder?

No. It doesn't cover doctor's visits, tests or hospital expenses. It only covers prescribed medicines directly related to the condition, and the HSE decide if it is related or not and have a fairly restricted list of what will be covered. http://www.hse.ie/eng/services/list/1/schemes/lti/

The_Conductor

echo beach wrote: »

No. It doesn't cover doctor's visits, tests or hospital expenses. It only covers prescribed medicines directly related to the condition, and the HSE decide if it is related or not and have a fairly restricted list of what will be covered. http://www.hse.ie/eng/services/list/1/schemes/lti/

Your consultant will specify which prescriptions are directly related to the illness- and they may- depending on the nature of the condition, be covered under the LTI scheme.

The scheme is under investigation- because it appears the rules of eligibility for both medications and also participants- are not being uniformly applied on a national basis by the HSE- the Ombudsman completed investigations into the LTI scheme- finding against the HSE- and instructing it to apply a more liberal interpretation of illnesses (for example ADHD in a child under 16 is now considered a 'mental illness' which is covered under the scheme).

There was a roadmap drawn up in 2013- which included, as a first step, the under 6 child visit scheme- which was trumpeted as the first step on a template for (eventual) free GP visit cards for all.

Originally a free GP visit card was to have been given to all LTI holders- however, this was ruled as unfair and inequitable- given the constrained list of conditions covered by the card. It was revised- such that holders of DPS cards who habitually spent the full 144 Euro a month on prescriptions, would, on an age stratified basis, be eligible for a free GP visit card. The Irish pharmacy union voiced concerns that the HSE measure for this- was before a 20% markup for medications under the LTI scheme (and the allowed markup for other schemes such as medical cards)- so those who were paying directly for their own medication- who for one reason or another did not have a medical card and/or an LTI card- would be unfairly advantaged.

Then the whole scheme was put on ice- until it was reawakened with the eventual roll-out of the free GP card for the under 6s.

The proposal has seen several revisions in how it was to be structured and rolled out- it was when it was determined that the LTI scheme and the very restricted list of conditions it covers, would be unfair and inequitable to be used as a template- that things went skew-ways. First off- there have been several legitimate campaigns by various groups to have many lifelong serious illnesses added to the LTI scheme. The HSE challenged this on cost grounds. The HSE then challenged the LTI scheme itself on cost grounds- insisting it should be means tested- and a fairer solution would be abandon the scheme in its entirety- and move all participants onto the 144 a month DPS scheme or give them a means tested medical card. It was thought this would save 70-80 million a year- according to Dáil reports.

The entire proposal was quietly shelved in 2013- as unworkable- ultimately on cost grounds- but also, because there was no fair manner of using the LTI scheme as a template to give GP visitation cards to those with life long illnesses- given the constrained nature of the scheme and the inequitable manner in which it was being applied for legitimate applicants (as per the cases decided by the Ombudsman).

Current proposal (insofar as there is one)- abolition of the LTI scheme, migration of all current LTI scheme members onto the DPS scheme, issuance of means based medical to cards to those whose means justify it, GP cards to issue those who pay the max (144) a month on the DPS scheme- on a staggered basis (by age group- starting with the young and the elderly). This would all be done independently of the pre-existing medical cards and their entitlements. Ultimately- it would cover all age categories- and GP visits would ultimately for all intents and purposes, be included in the DPS scheme under the 144 a month (aka your monthly max for prescriptions and GP visits would top out at 144 a month- for those who did not qualify for a means tested medical card).

This is also dead in the water- as the pharmacists and the GPs- are unlikely to agree to it- though the IT infrastructure is in place to support such a scheme (allegedly- whether it works or not is open to interpretation).

locum-motion

The_Conductor wrote: »

Your consultant will specify which prescriptions are directly related to the illness- and they may- depending on the nature of the condition, be covered under the LTI scheme...

Hmmm... Yes and no!

The HSE have published a series of 'core lists' - lists of medications that will be covered automatically for each of the specified Long Term Illnesses.

If your doctor wishes to prescribe a medication that isn't on the list for your Illness, then the doctor can apply to the HSE to have it covered in your case.

There are some medicines that do not appear on the core lists for which I have seen authorisations (for example, sildenafil for a diabetic patient), but in all such cases the authorisation pre-dated the issuance of the core lists.

Since they were published, I have yet to see a 'non-core-list' medicine authorised.

uli84

7 years later still nothing happened pretty sad actually