Debate resumed on amendment No. 1: To delete all words after "Dáil Éireann" and substitute the following: "notes that: -- there has been no change to the manner in which discretionary medical cards are awarded; -- there is no target set in the Health Service Executive (HSE) National Service Plan to reduce the number of discretionary medical cards; -- of the 24,000 reduction in discretionary medical cards from the start of 2011 to July 2013 almost 23,000 of these persons have been awarded medical cards on the basis of their financial means; -- the HSE has produced National Assessment Guidelines to provide a clear framework to assist in making reasonable, consistent and equitable decisions when assessing applicants; -- these guidelines facilitate the application of discretion by decision makers in responding to the needs of the applicant when additional or exceptional circumstances exist; -- the Health Act 1970 (as amended) provides that persons who 'are unable without undue-hardship to arrange general practitioner' services for themselves and their family qualify for a medical card; -- in accordance with the Health Act 1970 (as amended), the assessment for a medical card must 'have regard to the overall financial situation' of an applicant and dependants; and -- the centralisation of the processing of medical cards at a national level, rather than at a local level as was the case before mid-2011, facilitates the assessment of applicants for medical cards in a consistent and equitable manner; commends the Minister for Health for directing the HSE to set up a clinical panel to assist in the processing of applications for discretionary medical cards, where there are difficult personal circumstances; further notes that: -- between mid-March 2011 and end-August 2013, the number of individuals who had eligibility to a medical card increased by 214,244 (13 per cent) to 1,863,062; and -- the HSE is facing significant challenges in 2013 and in 2014 given the need to set expenditure levels within the parameters of the National Recovery Plan; and acknowledges: -- the significant reductions in financial and staffing resources which the health sector has experienced over the last three years; and -- the range of measures being actively progressed by the HSE to manage its financial resources to ensure that services are provided to persons entitled to receive them; and commends: -- the Minister for Health and the Government for providing resources to meet the increase of over 200,000 medical cards since March 2011; -- the Minister for the passing of legislation to abolish restrictions on general practitioners wishing to become contractors under the medical card scheme; -- the Minister on the implementation of legislation to achieve savings under the medical card scheme through the use of generic drugs and reference pricing; and -- the Minister on the savings being made in the cost of drugs for the medical card scheme through negotiations with pharmaceutical drug suppliers." -(Minister of State at the Department of Health, Deputy Alex White).

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