Enda Kenny (Mayo, Fine Gael) | Oireachtas source

In regard to the cases highlighted, the facilities, aids and appliances required by a sick child or adult are met by the long term illness scheme. The question that arises is how far can we stretch discretion given the equality of assessment that applies in terms of the income limits. I have been informed by the HSE that it has been flexible in dealing with individual cases. I accept that in centralising applications to one database cases can be missed and that the nature of the machine is that it does not recognise the circumstances in which people find themselves. I, too, have dealt with a number of these cases.

I understand that members of the family mentioned by the Deputy were in discussions about the matter today with personnel from the HSE. A series of presentations are being made regarding automatic qualification for a full medical card depending on the nature of a person's condition or circumstances. As the Deputy will be aware, the system provides for a full medical card, long term illness entitlement, a discretionary medical card and an emergency medical card. The problem that arises is if one decides to change the law in respect of particular categories, which may include people whose cases are very difficult to deal with, how far does one go? As I understand it, it is estimated an additional 250,000 people will be diagnosed diabetic in the next ten years.

I engaged early this morning with the HSE about these cases and will engage further on the matter tomorrow with medical personnel. I accept that the review process in the context of the sharing of information between the Revenue Commissioners, the Department of Health and the Department of Social Protection results in an assessment of approximately 80,000 cases per month. In this regard 30,000 people are never written to because it is clear they are entitled to a full card and 30,000 are asked to report on whether their conditions have changed and so on. Some of the remaining cases can be problematic. Nobody wants to see any child left without assistance.

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