Ms Emma-Jane Morgan:

There are certain things that are outside the scope of the scheme. If something is not publicly available within our legislation, it is not covered by the scheme. Equally, long-term care, public vaccination programmes and, if I am correct, enzyme replacement would not be covered but they are very small so a broad range of access to general healthcare services available in this State is covered by the scheme. There does not tend to be many refusals on the basis that something is not covered.

In respect of the future of the scheme, the removal of upfront payments is under consideration and is forming part of our analysis. It is a difficult one. If we remove it and make it even more affordable, we will create a capacity issue. We do not want to create waiting lists for this scheme either. We need to look at the benefits and drawbacks of such an approach. The benefits would certainly be for patients but, ultimately, what would this mean in terms of demand and availability of access to facilities in the North or other EU countries? We also need to look at the financial implications of that for the Exchequer, what that would mean for the State and if there are wider implications. For example, if people fall back on this scheme where they do not have to pay up front, what would people do around their private health insurance? Would they continue to hold it? They are the wider policy issues that need to be looked at and that form part of our considerations as we look to develop the scheme.