Enda Kenny (Mayo, Fine Gael) | Oireachtas source

I do not want to comment on the details of a particular case. In some cases, a card was refused on the basis of income. The Keane report commissioned by the Minister considered whether cards could be granted on the basis of an illness and it indicated that this was not morally, ethically or in any case justified. The application process goes back to the element of discretion. An application would be made and the case of a child or children would be considered by discretion. That process is much more flexible than it used to be. There has been an increase from approximately 52,000 discretionary cards issued in the middle of last year to over 77,000 at the end of December 2014. There is a far greater degree of common sense and sensitivity applied here. There is also the question of checks with local medical and health officials to see if there are local issues or changes in circumstances that apply.

I note the Deputy's comment in respect of the first case he mentioned, where one of the parents has given up work. That would lead to a change in income circumstances for the family. Access to facilities and treatment is important in these cases, including issues that might arise for the children involved. My understanding of the second case is that the child has access to the long-term illness and GP card, as well as the facilities that the child needs. I understand that whatever is the medical requirement of the child has been approved. If the child needs orthopaedic shoes, they will also be made available, depending on when the child would be fitted.

I do not have the details of individual cases around the country. The Minister has made it very clear that we need a degree of common sense and, where discretion has to be considered, it should apply. If the Deputy has different information, I will certainly make it available to the Minister for Health, who is very anxious about these issues. Nobody wants a case of a sick child not having access to medical facilities and treatment. As has been indicated, until one gets to a universal health scheme, there will always be people over the limit for a medical card application. This leads to the question of discretion for circumstances that arise.

Without detailing the individual circumstances of children or any individual here, I hope the point mentioned by the Deputy about a change of circumstances in the case is checked. I do not accept that there should be a wait of 12 months before a decision can be made about a discretionary card, as that is clearly not true if we have gone from 52,000 to 77,000 discretionary cards issued in the past six months.

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