Alex White (Dublin South, Labour) | Oireachtas source

It was not a concession. The Deputy should give it a fair chance. How else will we address the two-tier system? If Deputy Kelleher says it should not be through insurance, what is the alternative for addressing the two-tier system we undoubtedly have? Let us have that debate.

I mentioned the wider context and the reduction in pay in the public service. The clear stated position of the Government is that it does not intend to further reduce wages in the public service. We can have the confidence to say that this applies equally to the FEMPI cuts, which is the issue that has most concerned doctors. It is my confident belief that the Government will not be going back to that well again and that people can have some level of certainty in terms of where they are going in the future. That is an issue of Government policy and I am simply reflecting what has been said by others in that regard.

Deputy Kelleher pulled me up again on the use of the word "discretion" in respect of medical cards. I do not want to get into semantics but the Deputy has drawn me into it. The Deputy's own question asked the Minister for Health to provide details of the number of medical cards and GP cards and the number of each card issued on a discretionary basis. The card is the card no matter how the person acquires it. If citizen A has a medical card granted in the normal way and citizen B has a medical card granted on through the discretionary process, the cards are exactly the same. That is the point I was trying to make. I was trying to say that there is no separate entity called a discretionary medical card. If two people are holding the card, the cards are exactly the same in terms of entitlement. Deputy Kelleher knows exactly what I meant by that but he persists in coming back and pulling us up on it. That is the position. There are two different routes - one is the basic means test and the other is through discretion. That is what we mean in terms of there being no separate entity.

Deputy Kelleher said that there was a belief on the part of Down's syndrome advocacy groups that there was a blatant attempt to reduce medical cards issued to their members. We have previously dealt with this issue, which I know is of concern to people and has been constantly raised in the committee. I want to state categorically that there is no targeting of people with particular illnesses or conditions. It would be perverse for the HSE to decide that it will go after this or that patient group and take away their medical cards. Even if I am wrong on that and there was an extraordinary policy of targeting particular patient groups, it could not be done anyway because the system does not retain information in respect of medical condition or illness. I want to again state that it would be impossible to do this. It would be perverse if anybody was to think that one would go after particular groups but the system is simply not geared to do that in any event.