Mr. Tony O'Brien:

I will address the specifics of the high-level piece. I do not think anyone in the HSE has suggested that there is no problem. It is a question of what our definition of the problem is. We are administering the scheme as it stands. The scheme does not do all that we would wish it to do. I do not think that the fundamental problem relates to the way the scheme is being administered. It is being administered in accordance with the legislation as it exists and the resources provided to it. What we are really having is a discussion about what the scheme should be as opposed to what it is. We can all relate to that discussion.

In respect of the specific issue raised by Senator O'Brien regarding the unfortunate birth of a palliative baby and the way that case was dealt with, we will certainly review our procedures to see if we can come up with a better way of managing that.

The salary of €340,000 is not being paid by the HSE. I can tell the Senator that it is not in agency that is fully funded by the HSE. I do not know which agency it is. I am assuming it is a section 39 agency, of which there are many from very small to very large. I can only assume it is an entity that has very substantial external funding but they will all be subject to an audit review to ensure that public funds are not used to support excessive salaries such as that salary. Obviously, in respect of the services we buy, we look for value for money in respect of the quantum of service we receive for the funding we provide. Nothing I say is intended to take away from the particular situation experienced or described by Senator O'Brien and her colleagues but what we have is a plea for a different type of medical card system - a universal one.