Alex White (Dublin South, Labour) | Oireachtas source

I have listened carefully to what the Deputy said and take her point on Down's syndrome and the difficulties she noted in the application of the long-term illness scheme to persons classed as having Down's syndrome. I was not aware that there was a particular issue in that regard, but I am willing to examine the specific problem the Deputy has identified. As I indicated, Down's syndrome is classed as a qualifying condition under the mental handicap heading. "Mental handicap" is not a term we use nowadays, but it is taken from the 1971 scheme. We are reviewing the entire operation of the LTI scheme and the classification of different conditions may be one of the issues we ought to examine. The general operation and application of the scheme is under review and we can and will address some of the issues the Deputy has raised in the course of that review.

My general approach to the medical card scheme and the issue of access to GP care is that we should have a universal system. We should not devise new schemes based on illness or conditions, with all of the complexities that go with this. The Deputy has identified some of the difficulties, including how to define various conditions in terms of whether they fall into categories. What is the diagnostic basis and do people constantly have to undergo assessments? Is there an appeals process and do they really have a qualifying condition? None of these matters should apply in providing access to basic health services, particularly GP care. That is why the Government is committed, with the support of the vast majority of Members of this House, to having a universal system of access to GP services. In such a system we would get away from the notion of people having to demonstrate they have this or that condition under this or that category, as defined in 1971. The LTI scheme is a drugs scheme, but there should be universal access to GP care, which is what we are dedicated to achieving.

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