Mr. John Hennessy:

Thank you Deputy Harris. We took action on our communications strategy in acknowledgement of the considerable amount of controversy and genuine anxiety and concern the announcement of the review provoked. The intention of our response was to explain, to clarify and to improve people's understanding of the operation of the medical card scheme in order to alleviate some of their anxiety and concern. In terms of the elements of the communications plan, Mr. Burke and his colleagues in the Primary Care Reimbursement Service, PCRS, introduced an additional control, particularly for people who already held discretionary cards. That is an important measure which allows us to capture the most up-to-date information on the circumstances of all cases before final decisions are taken. That control is now in place.

The second element of the communications strategy involved public advertisements, an enhanced helpline and website enhancements, including a new video. I would encourage all Deputies to look at the video on our website if they get a chance. It is not lengthy, at approximately eight minutes, but is quite informative. We are working on a frequently-asked questions leaflet for medical cards which will be ready in about two weeks and will go to all local offices, GP surgeries and hospitals as well as being circulated to public representatives. We have embarked on a range of meetings and briefing sessions with voluntary and advocacy groups. We have also embarked on a number of briefings in the political system through the local health fora.

The third element of the communications plan involved a re-working of our written communications. We came in for some criticism for the tone and language used in some of our written communications with the public. A review of the notification letters, in particular, is underway. The language is being personalised and we are enhancing the information that is provided for applicants, particularly with regard to the range of entitlements to services that people have which do not require a medical card. That might help to reassure people that losing their medical card is not necessarily a catastrophic event, given that a range of other services and entitlements is still available to them.

The final element concerns the issue of discretion. We are trying to explain that discretion is still available but that it is now being applied in a consistent, fair and equitable manner. Medical officers are involved in the process and carry out individual, case-by-case assessments. They pick up the phone and speak to the applicant's GP or consultant, as necessary. Obviously, the ultimate objective is to ensure the people who need a card get one but the scheme operates within the confines of the statute and the resources available to us.