Mr. Tony O'Brien:

I refer to the Deputy's question about pricing. The savings this year from reference pricing are on target at about €50 million, which is a substantial benefit.

On the question of medical cards, including discretionary medical cards, to be clear, a person who wishes to apply for a discretionary medical card can still do so. Over 5,000 such medical cards have been issued this year and during the period of review and the suspension of reviews we have not suspended the scheme. Those who have particular needs arising from the cost of treating a medical condition are still eligible to apply and will be granted a medical card if they qualify.

To answer the Deputy's specific questions on eligibility, it is important that the scheme be accessible on a national basis without regional variations. While there are many negatives arising from the review process as it relates to discretionary medical cards, it has achieved one thing in that it has clearly surfaced that there were wide geographical inequalities in terms of who could and could not receive medical cards on a discretionary basis. That local variation meant that people who probably did not conform with the rules as they stood at the time were receiving medical cards in one area, whereas others in another area had to pass the strict test. I do not think that going back to that system is the right thing to do. There is a process in place to determine what medical conditions it might be appropriate to include in terms of eligibility in circumstances where it would not arise. As this is a process that will ultimately result in consideration by the Government, I would not want to prejudge it. We have established the expert group which will look at the medical conditions which could be included in addition to or in substitution for the undue hardship test. Our report is due for completion in September and will then be considered by the Government which will also be provided with information on the resource implications of each of these options. I do not think a return to the way medical cards were issued would solve the current problem.