Kieran O'Donnell (Limerick City, Fine Gael) | Oireachtas source

My point is that those 6,324 people have a serious medical condition. In the cases that have come across my desk many of them are disabled children or children with Down's syndrome. They would have had medical cards since birth or from the first year of their lives. I am talking about the system; this is not personal. It is an important issue. Let us say a person has Down's syndrome and he or she is offered a long-term illness card under the mental handicap heading, a term that must be changed as it has been used since 1970. It is outdated and I have major problems with it. Let us consider the conditions that invariably occur with a child who has Down's syndrome. Up to 90% of such children have asthma, 70% to 80% suffer from hearing loss, while 80% to 90% will have heart conditions, yet when they receive the long-term illness card, they are not covered for any of these. Does that make sense, given all the time it takes to administer these 6,324 applications for people who are seriously ill, have had medical cards for the past ten years and are a vulnerable group? We are dealing with their parents who are under extraordinary pressure. In some cases, they do not have the time to put together what is needed for an application, but if they are offered a long-term illness card, it will not cover virtually all of the conditions from which their child is suffering. Along with this, when a review was carried out of a cohort of 428,682 and 9% of these, nearly 36,000, did not reply, is it value for money to chase down the discretionary medical card scheme for this small cohort of 6,324 people? They account for a minute percentage of the GMS cards issued. There are up to 1.9 million cards issued; perhaps, therefore, it would be better value to carry out a review of these categories. The point is that this is a group of people who received medical cards because there was a serious illness from the start. I am trying to see the logic of it and whether there is a need to change the system to deal with this issue. It all dates back to 1970. Will Mr. O'Brien address that issue? Does he understand our motivation?