Simon Harris (Wicklow, Fine Gael) | Oireachtas source

There are a couple of points to note. Let me be clear and say that there is no financial need or incentive to be carrying out spot checks now. In terms of the surplus that PCRS actually found itself with at the end of 2016, unlike in previous years when previous Ministers for Health found themselves in very difficult situations regarding medical cards, that financial necessity is not there. What is a necessity is that we ensure that the system is administered in line with the law. If we do not like the law there is an onus on us to change it. That is why we are going to change the law, I hope, on the domiciliary care allowance, DCA. The reviews that the Deputy talks about for that cohort of people, which is 33,000 people - quite a few - will cease. It is hugely expensive and time consuming for both the resource within the HSE. One would be better employed turning around more medical card applications for patients to achieve that target.

It is also worth pointing out that the clinical advisory group that was set up by my predecessors to tackle the question that the Deputy is referring to is doing important work. Its first recommendation, which was adopted by the director general, was that any child under the age of 18 with cancer should be provided with an automatic entitlement to a medical card for five years. That was a very welcome development. The next step now, and the director general made this point when he was here last week, is to look at how we can apply that process to all cancer patients. The clinical advisory group, which includes representatives from Our Children's Health, Patients for Patient Safety Ireland and medics has been looking at this. My own policy perspective on this is that where people have a clear medical need and a condition that requires access to a medical card the more straightforward we can make that process as legislators the better, because it avoids all the hoops that people have to jump through. Today we are making good progress on a cohort of 33,000. The move that we have already made around children with cancer is another cohort of patients who should not have to go through a bureaucratic process. The next body of work I will be moving on to will concern other conditions, including cancer.