James Reilly (Dublin North, Fine Gael) | Oireachtas source

There is compassion in the system, which is why I asked for a panel of doctors to be put in to help in the area. They go to great lengths to ensure that people get a medical card but it does not always work out that way. We have had people with very serious illnesses, and as Deputy Kelleher noted, on a compassionate basis one might say they should get a medical card, but their income could be a couple of thousand euro per week. We must bear that in mind when there are other people out there who do not have a medical card and whose income is only a couple of hundred euro per week. That is the difficulty.

The initial goal was to give all those people with specific conditions on the long-term illness card a medical card but the technicalities around trying to achieve that were proving so onerous, it would have taken a couple of years to complete the task, and this was only a temporary phase on the way to free GP care. We would have needed panels of doctors to verify conditions and continuously required monitoring to see if people's positions had changed. It seemed to be such an onerous administrative nightmare that it seemed easier to progress the matter through age cohorts.

We are still fully committed to free GP care in the Government and it remains our ambition. I hope the position of the country will improve in the next couple of years, making that possible. There is no campaign in the HSE to go after people with discretionary medical cards. I have issued an instruction that there should not be, and the Minister of State, Deputy White, is very much in the same space as me. There will always be hard cases and examples where on the surface one might want to issue a medical card. Either we run the system on a transparent set of rules - which was not the case in the past - or we do not. In that case, people in much less difficult circumstances in one part of the country will get medical cards but in other areas, people in much more grave difficulty will not get a card. That would be unfair.