Alex White (Dublin South, Labour) | Oireachtas source

On the Deputy's last point, I will not go back on what I said about having sympathy for the point raised by Deputy Caoimhghín Ó Caoláin which was supported by the Deputy and, perhaps, Deputy Seamus Healy. For example, if we were to consider in the context of the Bill a provision that referred to a serious illness or a serious congenital condition, we would be immediately embroiled in definitional issues, making determinations as to which illnesses and conditions were and were not to be included and, more importantly, on who should decide and on what basis they should do so. This is the problem we always have to address, that there is always a selection involved. That is one of the reasons I am a universalist. Ultimately, a person should not have to apply for health services and prove that he or she is sicker than someone else or that he or she has a long-term as opposed to a short-term condition, or that he or she will or will not recover. This dogs services and is one of the reasons I am a universalist. If we were to go down the road of providing for serious illnesses, serious congenital conditions and addressing the question of aftercare services, the criteria to be used, etc., we would be embroiled immediately in complexities and there is no way we would be able to do this without at least the assistance of the expert panel that we have asked to look at these issues and, ultimately, looking at the legislative basis for selecting some and not others. I will not be in a position to agree to an amendment to the Bill along the lines suggested by the Deputy, but I hope he hears from me that there is an absolute appreciation of the issue he is raising and the need for it to be accommodated in the system. I agree completely with him in that regard, but it will not be possible to accommodate the amendment in the Bill.

I thank Deputy Caoimhghín Ó Caoláin for stating he will "stay the course for now at least." That is fair and reasonable and I thank him for what he stated in good faith.

I emphasise that we cannot spend the €37 million set aside this year until we have the scheme in place. We must put it in place and then start to pay for services. That is the way it happens. We did say it would happen in June-July, but it will not. However, I see every possibility that it will be implemented by the autumn. That is a realistic prospect. We have got the framework for negotiations and consultation with the IMO and I am hopeful they will get under way quickly.

The figure of €13 million agreed to this week for discretionary medical cards is separate. It is not coming out of the pot of €37 million, as I have made very clear.