BackThe Ombudsman, Peter Tyndall, has today welcomed the steps taken by the Health Service Executive (HSE) to ensure that the Long Term Illness card scheme does not discriminate on the basis of where an applicant lives. The Ombudsman’s report, 'Local Rules for National Schemes - Inequities in the administration of the Long Term Illness Card Scheme’, follows a refusal by the HSE to award a Long Term Illness Card* (LTI card) to a boy diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). The HSE refused the LTI card on the grounds that the boy did not meet the medical criteria for eligibility. In her complaint to the Ombudsman, the boy’s mother, Ms Kelly (not her real name), contended that her son met the relevant medical criteria and she claimed that had he lived elsewhere in Ireland (he lives in Wexford), her son would have been awarded a LTI card.
Ombudsman Peter Tyndall, who succeeded Emily O’Reilly in December last, found that the application for the LTI card was treated unfairly. He also found that applications under the scheme were being treated differently by the HSE depending on their geographical location.
Following the intervention of the Ombudsman the HSE agreed to:
- Award Ms Kelly’s son a LTI card,
- Refund Ms Kelly the cost of medications for her son in the period from when she first made an application under the LTI scheme to the time when her application was granted (approx. €3,000),
- Uniformly administer the LTI scheme nationally, thereby including ADHD as constituting a mental illness which, in the case of persons under 16 years, gives entitlement to a LTI card.
The LTI card scheme is a statutory scheme administered by the HSE. Under the Health Acts the HSE has the power to make arrangements for the supply without charge of drugs, medicines or medical/surgical appliances to persons suffering from “a prescribed disease or disability of a permanent or long-term nature.” Regulations list the diseases or disabilities which qualify an applicant for the card. The illness with which this case is concerned is simply listed as “mental illness”. The relevant section says:
“Arrangements for the supply of drugs and medicines to persons suffering from mental illness ... shall be made only in respect of persons under the age of 16 years.”
This means that mental illness in a child under the age of 16 is an illness which qualifies for the LTI scheme so that the medications prescribed for that child may be obtained free of charge.
The Ombudsman’s full report, 'Local Rules for National Schemes - Inequities in the administration of the Long Term Illness Card Scheme’, and a summary of the report are available on the Ombudsman’s website.
Source: Irish Ombudsman
