Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I welcome Ms Hoey and her colleagues. On the figures for those who have taken up the under-six and over-70 schemes, 204,000 and 47,000, respectively, does the primary care reimbursement service, PCRS, have projected figures? How far short of what was expected are these figures? Is it the case a significant number may not have taken up the scheme to date? This information would be helpful.

I welcome the advances signalled in the area of information technology. The enhanced online application system is welcome. I also welcome the interface with the Department of Social Protection, which will eliminate the need for applicants or clients to provide details of their social protection payments. These developments are to be delivered in the coming year and are welcome.

The expert panel made a number of other recommendations in its report published in September 2014. I note medical officers and deciding officers at the NMCU are being enabled to gain a more comprehensive understanding of the burden of illness on an individual or family. This will be very much part of the assessment. Is it the case that the NMCU is seeking the green light for that refinement in 2016 from the HSE? The other two initiatives are current and, I presume, approved, but Ms Hoey said this refinement is being tested with a view to it being recommended to the HSE in the first quarter of 2016. What has the pilot programme shown and does the NMCU anticipate a favourable response to the recommendation?

Removing the means test for medical cards for children under 18 with a diagnosis of cancer is a welcome and important development. Does the PCRS have an opportunity to encourage further consideration of the medical need assessment rather than means or income stream assessment?

That is the case currently and I would argue it should be expanded.

The thresholds for qualification have been parked for many years. Although the representatives from the HSE, in their opening remarks, indicated that there has been a significant increase in the number of people who have medical cards in the ten years since 2005, has the qualification threshold increased over that period of time? I doubt that it has but the delegates can correct me if I am wrong. The threshold figures are unacceptably low in respect of the full medical card and the GP-visit card. Does the primary care reimbursement service have the wherewithal to recommend or would it even consider recommending that this particular barrier to access be revisited? I would much rather assessment on the basis of medical need. However, would the service recommend an increase to the thresholds if the alternative option of assessment based on medical need is not possible?

I also wish to deal with capacity in Finglas and the post office, PO, box number. We will have the anticipated addition of children from six years to 12 years in the last quarter of 2016 to the scheme. This is clear given the funding of €10 million for a scheme that would cost €39 million over a 12-month period. With the addition of the under-sixes and those over 70, does the HSE have the physical capacity and office space to accommodate the movement towards, it is hoped, at least, initially, universal free GP access? This will be done incrementally and will add additional work throughput. Does the HSE have the necessary physical space and staffing? What will the impact of schemes for the under-sixes and the over-70s be? Does the HSE anticipate more in terms of need?

Are the 2014 figures relating to the primary care reimbursement service available? The only figures I can access are those from 2013. What is the status of the 2014 figures relating to the performance of the funding stream to general practitioners, for example, through the primary care reimbursement service? Are the delegates in a position to answer the question? Perhaps I am wrong but I was endeavouring to establish this recently and was unable to isolate the information I needed. Are the delegates in a position to help me in this regard?

I thank the delegates for today's report. I am responding positively to the elements I believe are welcome and will make a difference and I am trying to be encouraging in respect of the areas I would like to see the service develop.