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 Header Item Medical Card Eligibility (Continued)
 Header Item Medicinal Products Licensing
 Header Item Other Questions
 Header Item Obesity Levels

Wednesday, 19 December 2012

Dáil Éireann Debate
Vol. 787 No. 4

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  3 o’clock

Deputy Alex White: Information on Alex White Zoom on Alex White The issue in regard to the inpatient charge, although related, is essentially a separate matter to the question of the discretionary allocation of medical cards on the basis of an applicant having a specific medical condition. There has never been an automatic entitlement to a medical card, even where a person is diagnosed with a debilitating and deeply stressful ailment, including cancer. The system does not provide for the automatic provision of a medical card in those circumstances. The individual concerned must submit an application. I certainly would expect any such application to be dealt with sensitively and expeditiously. If there was any sense in which that was not happening, it would give cause for concern. I reiterate, however, that there is no automatic entitlement. An application must be made and is assessed on the basis of the medical evidence. As I said, I agree that such applications ought to be expedited.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher The €75 charge is relevant because patients with a medical card are exempt from paying it. I accept that there has never been an automatic entitlement to a medical card. What is clear, however, is that the clinical review panel has raised the bar so high in terms of assessing entitlement based on medical need that applicants are increasingly failing to qualify. Of all the issues to be dealt with in the health service, this one is surely deserving of immediate attention. What is happening is at variance with what we are being told in the Dáil. I cannot countenance a situation where people in such circumstances are having their applications rejected by the clinical panel. I acknowledge that there never was an entitlement in this regard, but the situation in practice has, for many years, been that any person with cancer was granted a medical card on the basis of an assessment of need. That is no longer happening and such patients are being charged €75 upon admission to hospital for chemotherapy treatment. It is a very unfortunate development.

Deputy Alex White: Information on Alex White Zoom on Alex White At the risk of irritating the Deputy in regard to this sensitive issue, I am obliged to reiterate that there never was an automatic entitlement to a medical card for cancer patients.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher I did not claim there was. My point is that cards were, in practice, routinely granted to such patients on medical grounds.

Deputy Alex White: Information on Alex White Zoom on Alex White That continues to be the case. If the Deputy is aware of particular instances where this has not happened, we will be happy to examine them. We cannot, hand on heart, offer an absolute guarantee that every such application will be dealt with in an expeditious way, but it certainly should be. It is not clear to me that there has been the type of fundamental change in practice or approach the Deputy describes. As I said, if there are specific cases that have fallen through the cracks in terms of the application process, we would be anxious to address them.

Medicinal Products Licensing

 5. Deputy Luke 'Ming' Flanagan Information on Luke 'Ming' Flanagan Zoom on Luke 'Ming' Flanagan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when he will introduce legislation for the provision of cannabis-derived products for the relief of pain, spasticity and other effects of ailments such as multiple sclerosis, glaucoma and so on; and if he will make a statement on the matter.  [57362/12]

Deputy Alex White: Information on Alex White Zoom on Alex White My Department has been informed by the Irish Medicines Board, IMB, that it is in receipt of a market authorisation request from a manufacturer under the European Union's mutual recognition procedure for a medicinal product containing cannabis extract. This product is indicated for the relief of symptoms of spasticity for people with multiple sclerosis. Under the Misuse of Drugs Act 1977, the manufacture, production, preparation, sale, supply, distribution and possession of cannabis or cannabis-based medicinal products are unlawful except for the purposes of research.

My Department is examining how authorised cannabis-based medicinal products for patients suffering from multiple sclerosis may be legally prescribed by medical practitioners and used by patients for the treatment of MS in Ireland. In that respect, departmental officials have been engaging with experts to identify how best to legally describe authorised cannabis-based medicinal products while maintaining existing controls on cannabis and cannabis substances. While the legislative amendments required can be made by means of statutory instrument, the legal issues are complex. The matter is being progressed as quickly as possible in my Department and it is hoped to bring forward legislative proposals in early 2013.

Deputy Luke 'Ming' Flanagan: Information on Luke 'Ming' Flanagan Zoom on Luke 'Ming' Flanagan I welcome the undertaking that legislative proposals in this area will be brought forward early in the new year. We now have a situation where 22 separate national authorities in Europe and around the world have granted approval for the cannabis-derived product, Sativex, having recognised the important benefits it provides to multiple sclerosis patients with spasticity. Mr. Ed Holloway, head of care and services research with the MS Society in Britain, indicated recently that the Medicines and Healthcare products Regulatory Agency has examined the evidence surrounding Sativex and deemed it a safe and effective treatment for spasticity, paving the way for its licensing in that jurisdiction. This product is not the cure all some claim it to be, but it is helping people in countries throughout Europe and the world.

I hope the Minister of State will fulfil his undertaking that legislation will be introduced early next year. Increasing numbers of people are approaching me to discuss this issue. One man in particular told me a very sad story of how, in order to alleviate his pain and discomfort, he was forced to purchase cannabis from the types of people who shot Veronica Guerin. None of us likes to see money going in that direction. According to this man, he no longer has to wear a nappy when he uses these substances. He has latterly discovered a person in the North who can provide him with Sativex - this transaction is, of course, illegal - which he uses until it runs out, at which point he is forced to use nappies once again. I fully accept that science is not based on anecdote, and I am loath to take that approach myself. However, this person sees clear benefits from using the product in question. It is unfair to people in his circumstances if the current legislative deficit continues for much longer.

I am well known as a campaigner for the legalisation of cannabis for recreational use. This issue, however, is entirely separate. I would hate anybody to think I am seeking to piggyback on the medical need issue, which would be a disgusting strategy. The two issues are unrelated.

Deputy Alex White: Information on Alex White Zoom on Alex White The Deputy raises a very fair point. There is no undue delay in regard to this issue, on which I was briefed when I assumed office. I assure the Deputy that the matter is progressing. We have our own processes in this jurisdiction and cannot rely on licensing systems that are in place in other jurisdictions, although we can certainly have regard to them. The Minister and I are absolutely concerned to expedite the availability of any product that would give relief to persons suffering pain or discomfort such as the Deputy has described. We must proceed in the proper manner, however, and we will do so in as expeditious a fashion as possible.

Deputy Luke 'Ming' Flanagan: Information on Luke 'Ming' Flanagan Zoom on Luke 'Ming' Flanagan The people contacting me will be waiting with bated breath for progress on the matter. It is an issue that should have been dealt with a long time ago.

Unlike the Minister, Deputy James Reilly, I am not a medical expert. Perhaps he will undertake to look into the claims by certain individuals that tetrahydrocannabinol, or THC, which is the principal component in cannabis, can have positive impacts in the treatment of cancer. I have read a great deal about the matter but am slow to shout about it. My mother died of cancer and the last thing I want is for anybody to be given false hope. However, if there is anything in these claims, I am anxious that they be examined in due course.

Deputy Alex White: Information on Alex White Zoom on Alex White We have the very best technical advice available to us both inside and outside the Department. Matters such as the Deputy raised are reviewed as they arise.

Other Questions

Obesity Levels

 6. Deputy Alan Farrell Information on Alan Farrell Zoom on Alan Farrell asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will provide an update on proposals to reduce the €1.6 billion costs related to obesity to the Exchequer; and if he will make a statement on the matter. [56885/12]

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly The prevalence of overweight and obesity has risen steadily in recent times, with 61% of Irish adults now overweight or obese. The World Health Organization refers to the alarming speed with which obesity has increased in recent decades as a global epidemic.

  The recently published report, The cost of overweight and obesity on the island of Ireland, funded by safefood and conducted by University College Cork, provides reliable figures for the annual economic cost of weight related ill health in Ireland. Initial findings estimate the annual cost of overweight and obesity in the Republic of Ireland to be €1.13 billion. The direct health care costs are €398 million or 35% of total costs. This figure includes hospital, GP and drug costs. In addition, two thirds of the economic costs were indirect costs in reduced or lost productivity and absenteeism, which amounted to €728 million. These figures show that the extent of the problem is greater than previously estimated, as indicated in the extrapolated figure of €400 million in the 2005 national task force on obesity report.

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