Alex White (Dublin South, Labour) | Oireachtas source

I do not know. Deputy Ó Fearghaíl also asked a question in respect of the discretionary medical cards, in particular the issues that arose in debate in the House last year. The statistical reporting of the medical card scheme, which covers 1.9 million individuals at a point in time, is complex and dynamic. Therefore, it can be difficult or problematic to make direct comparisons between different reports of slightly different criteria, dates and timeframes.

There were two reports, one in autumn 2013 and another in spring 2014, indicating that approximately 7%, or one in 14, of discretionary medical cards were being refused renewal. The first report was a preliminary analysis for a Private Members' motion debate prepared at short notice. The later report was a more detailed analysis. Different analytical reports on discretionary medical cards since last autumn produced a number of estimates of lost discretionary cards, that is, cards that were not renewed - 1,696 medical cards in the preliminary analysis, covering January 2011 to June 2013; 5,860 medical and GP visit cards in the May analysis, covering January 2013 to March 2014; and 15,305 medical and GP visit cards in the June analysis, covering January 2013 to May 2014.

The information from these reports was referred to in the Dáil on many occasions. There was no policy to deliberately focus on discretionary cards or cards awarded through the discretionary process, and there was no specific target to cut such cards. There was a budgetary policy of improving the accuracy and probity of the medical card scheme and eligibility for medical cards generally. The Government has never denied that discretionary medical cards were not being renewed, nor did it downplay the numbers involved. The analysis suggested that a refusal rate of approximately 7% did not indicate what was alleged to be a wide-ranging cull of discretionary cards, as suggested in the media and elsewhere. Nonetheless, the Government kept the situation under review given that this area related to a number of people with medical conditions.

Earlier this month, another analysis of discretionary medical card numbers was carried out. This analysis looked at all discretionary medical cards refused renewal throughout the period since the centralisation of medical cards was completed in July 2011. That is the answer to Deputy Shortall's question as to why July 2011 was identified as the bookend at the outset of the period, because that was the time when the centralisation of the process was initiated. The previous reports indicated what happened to discretionary cards held at a point in time, whereas the report I am talking about now was over a period. This final analysis indicated that, throughout a three-year period, the renewal of approximately 15,300 discretionary medical cards and discretionary GP visit cards was refused as the person did not meet the eligibility criteria.

As the House is aware, the Government has decided to develop a policy framework for providing eligibility for health services on the basis of medical conditions, including new legislation as appropriate. This is a major change to eligibility for the health system, which has been based on means since the 1970 Health Act.

Deputy Ó Fearghaíl also raised an issue in respect of waiting times, which was also raised by another Deputy, and I will come to that. I welcome Deputy Ó Caoláin's acknowledgement that the election in regard to the Opticians Board is a technical matter. I recognise and acknowledge his support for that, or at least his non-opposition to it.

Deputy Naughten raised a number of different issues in respect of funding, of which I have taken note and which I understand. He also raised an issue with me before on Topical Issues in regard to paediatric palliative care and has raised the issue again today, perfectly legitimately. I am not in a position to deal with it in any detail today but I am taking careful note again of what he has said, at least by way of reminder to me. It is a fair point and is a matter I will seek to pursue for him. I will try to keep in contact with him in this regard.

An amendment was ruled out of order on Committee Stage, and Deputies Shortall and Naughten have raised this issue. I never know whether it is in order for me to talk about matters that were ruled out of order. However, I will talk about it-----

See this speech in context