Mr. Tony O'Brien:

I will add to the Minister of State, Deputy White’s comments on medical cards. I will also seek to address the concerns raised about the ambulance service. The degree of passion and concern expressed around health services that we often hear in questions is appropriate. I recognise that there is nothing more personal or, indeed, political than health care, particularly if something is seen not to be working as effectively as it might.

Regarding medical cards, the reason we do not hold data relating to a person’s medical condition where that condition has been factored into the calculations to determine whether someone would suffer under financial hardship and, therefore, qualify on discretionary grounds is that the medical condition itself is not a relevant decision making criterion. Under the Data Protection Act, we would not be entitled to hold those data. Only at such time as the law changes or situations evolve to where a medical condition becomes a qualifying criterion would we be entitled to classify claimants in that regard and hold those data.

That said, the discretion arises from the 1970 Act. It is important to stress that we have a mathematical formula for basic entitlement. In order to exercise discretion in a way that will withstand tests as to sound public administration, it must also be standardised. This has been done on the basis of a higher financial threshold calculated by reference to particular circumstances in particular cases. Since the discretion was, in effect, vested in the chief executives of the health boards at the time and, therefore, is now vested in me, I am conscious of the importance of the exercise of that discretion. We are constantly examining whether that discretion can be exercised in a different or better way. For now, though, we are using exactly the same approach that has been used for a number of years. To that extent, I can say definitively that there has been no change in policy or practice.

However, what appears to be clear is that, previously, there were regional variations. One of the effects of having a level playing field is that, as regards persons who may previously have been granted medical cards on discretionary grounds when they did not fulfil those narrow criteria, one will find on review that----