Mr. John Hennessy:

I will write to Deputy Sandra McLellan on the reimbursement of the named products as I do not have the information to hand. We could spend the day discussing how the discretionary medical card system works. Due to confidentiality reasons, I will not be able to speak about specific cases. These applications are treated extremely carefully as it is a statutory scheme. The decision-makers and medical assessors involved in the assessment take account of the impact of medical conditions. That is done by medical staff and includes ensuring children have access to the health services they need without undue hardship. The figures the Minister referred to earlier speak to that too, namely, that the number of discretionary medical cards has increased by 25,000 over the past six months.

Discretion is stretched to the limits available under the scheme. As the Deputy knows, a series of reforms are under way with the General Medical Services scheme. The first meeting of the clinical advisory group was held this week which will continue refining the discretionary medical card system further.

It must be borne in mind that the expert panel, when it considered this issue last year, could not distinguish between one medical condition and another where access to medical cards is concerned. In the end, it reverted to means as the only appropriate way to deal with it. As the Minister outlined, it must be remembered that people have access to health services regardless of whether they have medical cards. That includes hospital care, definitely cancer care, as well as the long-term illness scheme, the drugs payment scheme, grant support for the supply of equipment based on clinical need and therapy supports. Community intervention teams, which have been very active over recent weeks, are available to the entire population regardless of medical card status.

Medical officers have regard to the reality of medical conditions when doing their assessments and the impact of those conditions. The issue of hardship will always be a difficult one.