Under the terms of the general medical services scheme, a medical card holder is offered a choice of doctors participating in the scheme from which he or she can receive, free of cost, the full range of available services. Entry by general practitioners to the GMS scheme is by way of open competition which ensures that all participating doctors are competent to offer a professional and high level of patient care. While a medical card holder may not be able to continue with the particular doctor he or she may previously have had, I am, nevertheless, satisfied that the needs of medical card holders are met within the terms of the scheme.