GP visit card for people with long term illness

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