Mr. Patrick Burke:

To confirm, as both the Minister and the Secretary General have outlined, the policy is to give access to individuals without undue hardship to general practitioner, GP, services. What is different is the fact that there is a centralised processing operation. The Minister put that in context in terms of the number of reviews we conducted this year but 87% of those renewals were successful. We assess an individual on the basis of their means, and we apply discretion. The Minister has put on the record the fact that discretion was applied positively 36,000 times since 2011. This year alone, discretion was applied positively more than 23,000 times. In a positive way we have applied discretion this year but in reviewing applications we have also taken away eligibility from individuals who have left the jurisdiction or who are over the guidelines. As the Secretary General said, we provide that statement and therefore we do not have any difficulty if that statement setting out the rationale behind it is produced to anyone else.

Another point was made about the role of the GP. Three months before any card is reviewed we write to clients, and there may well be individuals who are challenged in terms of literacy or something like that but they do attend their GP. We have also provided GPs with the functionality to have that safety net.

GPs can extend eligibility for a further three months and so, in effect, each individual who will be reviewed has that window of nearly six months. We write three months in advance of the renewal date and a GP can extend the eligibility. Moreover, they have a vested interest because if they extend the eligibility, the capitation continues to be paid and they stay on their panel. I am simply answering the earlier point. Other than that, I believe most of the points have been covered. We do exercise discretion and, to use an analogy, we use the ethos whereby in the case of a student who has 38%, we try to make it 40%. However, as the Director General pointed out, while people with serious illness who have incomes within reasonable reach of the qualifying scales can qualify, it is very difficult for us when that income amounts to multiples of the scale, and they are the situations of the hard cases we find.