Mary Lou McDonald (Dublin Central, Sinn Fein) | Oireachtas source

Setting a target, or having a figure like that handed down, is the very definition of precooking an outcome. Mr. Hennessy, Mr. McLoughlin and Mr. O'Brien have been at pains to emphasise that there is no change in the qualifying criteria for a medical card, and specifically a discretionary medical card. The witnesses cited section 45 of the Health Act 1970 and have underscored the fact that legislation is what determines whether a card is awarded. I have no argument with that.

Moving from the general to the specific, a specific individual is a five-year-old child called Katie Connolly from Douglas in Cork. She has Down's syndrome and has been turned down on assessment for renewal of her medical card, which she had since birth as decided in line with section 45 of the Health Act 1970. She has Down's syndrome, asthma and a heart condition that must be monitored every two years. She has recently been diagnosed with juvenile arthritis. Her family always understood that on a simple crude means test they would not qualify for a card, but Katie had a medical card as adjudicated by the authorities in line with section 45 of the Health Act 1970. She now no longer has the card and she has no GP visit card.

In this specific case in which a child was judged as qualifying for a full medical card and is now judged not to qualify for any medical card, the legislation has not changed, the child's condition has not changed and the family's means have not changed. Those elements are constants in the scenario. Notwithstanding what he has said, Mr. O'Brien is dancing on the head of a pin and the one thing that has changed is the policy in respect of how eligibility is interpreted. How does Katie, aged five, find herself with no medical card? I would like to know that.