Ms Laverne McGuinness:

I apologise. In addition, there is public accountability for the money spent on medical cards to ensure everyone who has one is so entitled under the eligibility requirements. If there is a change in circumstances, for example, a salary increase, the onus is on the medical card's receiver to notify the PCRS and have a reassessment made, as he or she may no longer be entitled to a medical card.

To ensure probity, we initiated a random review this year of 1,500 medical cards, which takes in people over 70, those under 70 and discretionary medical card holders.

We were obliged to do that as part of our public accountability and we will be sitting before the Committee of Public Accounts to ensure that we are discharging our obligations in that regard. Discretionary medical cards have not been targeted, per se, as part of our random review of 1,500 medical cards. The other measure we are considering is the idea of inactive cards, and if somebody has not used a medical card for 12 months, we are writing to ask if the person is still resident in the State and needs the card. Those people would retain eligibility for a period of three to six months after this but after that we have an obligation to take back the card. This will ensure that the people who most need the cards get them.

As I indicated, 43% of the population is covered by medical cards, and at the request of the Minister we put in place a process where a medical doctor would consider the assessment for discretionary medical cards. In previous years there was a decentralised process which meant there could be inequities throughout the country; this means people may have been getting discretionary medical cards in some parts of the country and not in others because of the rule set, which has now been standardised. There will be equitable access for all people.