Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I will make two points. The first is on the discretionary cards. One in eight medical cards is discretionary, and that is meant to speak to exactly the kinds of cases the Deputy talks about. The discretionary medical card is issued to patients with big medical expenses. They might satisfy the gross income criterion but not the net income criterion. Once they have to pay all these medical expenses, they do not have enough money. That really is the purpose of the discretionary medical card. If the discretionary card is failing some people who really cannot afford their medical care or cannot pay their bills because of their medical care, we may need to review that. As I said, however, nearly 200,000 discretionary medical cards are live at the moment.

Second, the gap between having a medical card and not having one has shrunk, given the number of services we have made free or much more affordable in the past four to five years.

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