Topical Issue Debate

Court Accommodation Refurbishment

I am glad to have an opportunity to raise this important issue pertaining to the necessity of securing appropriate alternative facilities to enable District Court sittings to continue in Mullingar when the existing facilities are temporarily closed for upgrading, renovation and refurbishment. I thank the Ceann Comhairle for selecting this issue, which allows me to ventilate the concerns of all persons - users, practitioners, Garda personnel and business owners - who will be affected by a failure to secure in a timely fashion the requisite accommodation in Mullingar. This is particularly the case given significant accommodation is available in and around Mullingar which only needs to be examined and accredited.

I have been actively pursuing for a number of years the urgent necessity to refurbish and extend the current facilities at the courthouse in Mullingar to bring it up to the standard of modern courthouse that is now available in towns such as Longford and Tullamore. We just want parity in Mullingar by ensuring proper facilities are provided, including ancillary facilities in regard to family law, children in court and so on. I am glad to see this was incorporated as part of the Government's infrastructure stimulus package, which will be delivered by way of public private partnership. Construction work will likely commence next year and will take at least 18 to 24 months, meaning that alternative accommodation to enable the District Court sit in Mullingar will be needed for at least two years.

I appreciate the Courts Service is charged with responsibility in this area, so I am pre-empting what the Minister of State is going to tell me, namely, the Courts Service has responsibility. I am aware of that and know it is its job to seek out the alternative accommodation.

There are a number of buildings which would be available on weekdays and which would be eminently suitable for this important function and, indeed, would be secure, given there must be an adequate and appropriate level of security for judges and other persons. There have been unconfirmed rumours that the District Court sitting in Mullingar might have to relocate to Longford to sit in the courthouse there. This might seem to be a financially attractive option from the perspective of the OPW, given it is the Minister of State, Deputy Brian Hayes, who is present rather than the Minister for Justice and Equality. However, it would be far from suitable in terms of the Minister's budget when all of the additional costs and expenses associated with such a proposal are factored in, and I hope it is not even contemplated. It would mean up to 12 gardaí having to leave Mullingar seven days each month for seven scheduled sittings to deal with prosecution issues. From a practical perspective, where the accused person does not turn up and warrants have to be issued and executed, this means gardaí would have to embark on a trip back to Mullingar or the particular geographical area where the accused resides.

This would add a significant further cost and is far from convenient when compared with the situation if the court continues to sit at an alternative venue in Mullingar. While it is not ideal for the legal practitioners, they will nevertheless fulfil their primary duty to their clients. However, where legal aid is involved, this would lead to an increased cost for the client in terms of travel and so on, which has to be incurred by the legal practitioners. In addition, all of the relevant Courts Service officials, who are essential for the smooth and effective administration of the court, will also have to relocate for each sitting day - at least seven a month - and also for special court sittings and out-of-hours sittings, all contributing to additional costs, which can be avoided in the context of getting alternative suitable accommodation in Mullingar.

Of course, the public would be greatly inconvenienced and discommoded. It is at least an additional 40 minute journey from Longford to Mullingar. Many people do not have transport and 70% of the people involved in the District Court in Mullingar can access it quite readily; many can walk to court. The distance to Longford courthouse from Mullingar is up to 45 km, so it would be a significant disruption for the people who use it.

There are alternative venues. When Tullamore courthouse was being refurbished, I recall the sittings taking place in the GAA pavilion, which was an excellent facility. There are a number of such facilities in the Mullingar area which are of high quality and which could be examined. They comply with all the required safety features I have suggested. As was suggested previously, Columb Barracks in Mullingar, which is very close to my heart and for which I fought my own battle, is a huge facility which is in the ownership of the State and located in a very secure setting.

The Deputy is over time.

Surely, within the confines of a huge array of buildings, it is possible to secure necessary accommodation to enable the District Court to continue to sit in Mullingar during the course of renovation work at the existing courthouse.

On behalf of the Minister for Justice and Equality, Deputy Shatter, I wish to thank Deputy Penrose for raising the matter. I will not read out the paragraph about the independence of the courts, as we all know that.

We will take it as read.

Exactly. My understanding is that the Minister has made inquiries on this issue and the Courts Service has informed him it is aware of the importance of maintaining court sittings in Mullingar during the period of construction for the refurbishment and extension of the courthouse. The Courts Service has indicated that the courthouse in Mullingar is in poor condition and the need for an improvement in accommodation has been clear for a number of years. The Minister is informed that a refurbishment project which was planned in 2009 was unable to proceed due to the reduction in capital funding at that time. The Circuit Court no longer sits in Mullingar and it has been necessary to relocate the court office from the courthouse to alternative premises nearby.

It is understood that the new courthouse will provide all the necessary accommodation and other facilities required for the administration of justice, including appropriate custody facilities and consultation areas, and it will increase the number of courtrooms from two to three. This will ensure that the facilities will comply with modern standards for court accommodation and that the needs of all users will be met.

The Mullingar courthouse development project is one of seven courthouse projects to be delivered by way of public private partnerships under the Government's infrastructure stimulus package, and the good news is that these are now again underway after a four-year period where no movement was occurring.

The procurement for these projects is being undertaken by the National Development Finance Agency and the procurement process will begin in the near future. It is expected that construction work on the Mullingar courthouse will commence during 2015 with the project being completed and the courthouse becoming operational during 2016 or early in 2017. As the Deputy recognises, temporary courtroom and office accommodation will be required for the construction period as the courthouse will have to be vacated.

The Minister is informed that the Courts Service, with the assistance of the Office of Public Works, is currently looking at possible locations for temporary courtroom accommodation for the duration of the construction period. I will not put all the other stuff, which is probably padding, on the record. I conclude by saying that I will take the initiative now and put in place a meeting between the Courts Service and my Department urgently to report back directly to Deputy Penrose regarding the important matter he has raised and see whether we can get a better fit between now and the next two years when the refurbishment works must be done.

It is fortuitous that the Minister of State is here because he is a practical person. I am glad he is taking this debate notwithstanding the fact that it is part of the Minister for Justice and Equality's portfolio. I am very glad of that. The Minister for Justice and Equality and I are very good friends. Looking at it on straight line economics, one place the OPW has already indicated costs of €250,000 to fit out. The judge just needs his or her own room for chambers and an ordinary room to secure. That is available at some of the GAA facilities so it would be foolhardy economics for the OPW to just use straight line economics because it would cost a fortune for two years for all of the people to go down - legal aid practitioners, the OPW's own core staff or gardaí. Mullingar has already lost Circuit Court sittings to Tullamore so we are waiting for this court. Businesses are entitled to it. There is a lot of activity around court days and money is spent so Mullingar is already losing out and I do not want to see it losing out further. The Minister of State can solve the problem. Columb Barracks takes up a huge area. I know because I sacrificed everything for it. Let me see whether I can get one thing back. Do it for me personally. Let us get one thing back and put the court in there for the next two years and utilise it. It will save the Minister of State money, he can spend a few bob here and there dickying it up and making sure it is accessible for Judge Hughes or visiting judges who come to carry out their important functions in the administration of justice. I appeal to the Minister of State. I know from his own practical common sense that he will do something.

Even though the Deputy's sacrifices have been many and great, he is looking well on the strength of them. The Courts Service funds all of this. We give it advice and see if we can find a fit or help it. The OPW is really a kind of shared service right across the public sector. Let us set up a meeting to see if we can make progress on this bringing the Courts Service and my colleagues in the OPW together with the Deputy over the course of next week.

Schools Building Projects Administration

I thank the Ceann Comhairle for selecting this topic. I have had it tabled for a good few weeks and I really appreciate it. I am disappointed the Minister for Education and Skills is not here but I appreciate that the Minister for State, Deputy Cannon, is here so he will have some understanding of what I am trying to say. All the Deputies in the constituency of Kildare North have been fully supportive of the proposals put forward by the Maynooth Schools Group. I met the group last night so what I am telling the Minister of State is fairly fresh. My personal interest is that I was a former teacher in Maynooth post-primary school. I was lucky enough to be there for a year so I could see at first hand the benefit of a "one school for one town" philosophy. In his interim report to County Kildare VEC, Dr. Gerry Jeffers states that "Maynooth has been an exemplar of inclusive co­educational, multidenominational schooling". I believe this is due to the elusive achievement of having one school for all pupils, which so many towns in Ireland would strive to reach. However, what the Department and Kildare and Wicklow Education and Training Board have proposed is to strip away all that Maynooth has achieved and create a divided community.

The community of Maynooth is central to this debate. The community was led to believe that the existing policy of "one school for one town" would be maintained and that the new campus would house all students attending Maynooth post-primary school. The news that two separate schools were to be established has been met with dismay, anger and concern about the future of the town. According to Dr. Jeffers's report:

The strongest single theme emanating from the public conversations with parents, particularly in Maynooth itself, centred on the idea of the town (population 13,617) as a unified community, in the words of a number of contributors, 'an extended village', where the single second-level school, Maynooth post-primary (current enrolment 1,175), acts as a powerful integrating force.

It is inevitable that two schools would create duplication and intra-community rivalry.

Solutions being put forward by the Maynooth Schools Group include amalgamation of the two schools, which is the key. One school board will decide the overall configuration of the facilities and an overall principal for the Maynooth post-primary school will delegate day-to-day management of its constituent parts to individual deputy principals. This is a reasonable attitude on the part of the community. The amalgamation can be on a permanent basis or on a temporary-pilot basis to be reviewed after five to six years or when the new school buildings are built.

There are real concerns on the part of parents. Only in essence is there a Maynooth Community College - there is no building and principal and there are no staff. How can sixth-class children prepare for entering second-level school in eight months when they have no idea where they will be, who their teachers will be or who their classmates will be, particularly when the prospective pupils and parents of Maynooth post-primary school are invited to attend an information meeting at the end of the month to meet teachers and hear about their subject choices?

This brings me to the new enrolment policy of Maynooth post-primary school, which is extremely worrying for many parents and pupils, particularly those who have children currently attending the school and studying through the Irish stream whose siblings are now being excluded from enrolment. I cannot understand how this is allowed to happen. The language medium through which a child learns should have no bearing on where their younger siblings attend school. If parents had been aware of this when they first opted for the Irish stream, they would surely have thought twice about sending their children there.

All the community of Maynooth is asking for is that its views be understood and heard. At the moment, it believes that it is being completely excluded from the process because its views, which it thought were being taken on board, were ignored. The Minister is an inclusive Minister who is actively engaging with parents on a number of issues which affect their children, most recently that of patronage. I am asking him on behalf of a unified community of Maynooth to listen to its call for "one school for one town" and not to divide it.

I thank the Deputy for giving me an opportunity to provide the House with an update on this issue. I understand that the Minister met parents' representatives on a number of occasions and also met Deputies Stagg and Durkan regarding this issue. I am glad to be able to provide an update as a result of those ongoing discussions. The Department's plan for Maynooth at post-primary level is that there will be two separate fully vertical post-primary schools on one campus, namely, a new replacement building for the existing Maynooth post-primary school and a new school, Maynooth Community College, which is being established in 2014.

Representatives of the parents' associations from Maynooth initially put forward the view that the two schools should be configured as a junior school-senior school rather than as two separate fully vertical schools. This proposal presented difficulties, not least of which is the considerable stress that would be caused for parents and students with the introduction of a third transfer point between primary and third level and the lack of continuity of teaching for students between the junior and senior cycle. The Minister has communicated this view to local representatives directly and I understand that a more recent proposal has been put forward which moves away from the junior-senior configuration. This is a very welcome development in the ongoing discussion.

The Minister is more than aware of the desire locally to avoid issues of duplication or intra-community rivalry in the establishment of a second school and this has resulted in a new proposal from the parents' group to amalgamate the two schools, either temporarily or permanently. The Minister believes, however, that there are a number of practical operational policy measures that can be taken, with the agreement of parents and school leadership, to foster a stronger sense of common identity and to benefit from the advantages of shared resources while maintaining two separate school entities.

My Department will now be engaging with the Kildare and Wicklow Education and Training Board, ETB, to consider this and I expect that it will, in turn, be engaging further with the school leadership, parents and the community as a whole in this regard.

As part of an earlier effort to address this issue, the Kildare and Wicklow ETB, which will be patron of both schools, has developed a specific management structure for the new educational campus. Each school will have, as usual, a board of management that will carry out the normal functions of such boards, including those relating to the delivery of a quality education for students. A single governing authority has been established to guarantee to parents and students a fair and equitable enrolment policy for both schools and to ensure that the overall management of the campus will be as cohesive and effective as possible. The governing authority will comprise an independent chairperson, the principals of the schools, a teacher and parent-guardian nominated by the board of management of each school and members of the ETB. The CEO of the ETB or a nominee will also attend meetings.

The Minister is satisfied that the arrangements made by the ETB to date and the further engagement on school operational policies that will now take place will ensure that the educational needs of all students, including those with disabilities or special educational needs, are identified and provided for in the curricular programmes planned and delivered at the schools and that a quality teaching and learning environment for all students will result.

As the Deputy knows full well from having taught there, the existing post-primary school in Maynooth is highly regarded locally. The intention of the ETB is to build on that wonderful tradition of high standards and success and to provide a new community education campus comprising two fully vertical new schools. There is significant and worthwhile thinking behind their establishment. I suggest to the Deputy that this will have a positive outcome for the community as a whole.

I thank the Minister of State for his reply. This plan does not satisfy the community's needs. When I attended a meeting one and a half years ago, it was clear that the community wanted a single school. The idea of two vertical schools is not that school. The community discussed an amalgamation of the two under one board, one principal and one school uniform. Maynooth post-primary school is highly successful and well run and has catered to the united community for many years.

Sometimes, it is important for us as politicians to listen to what the community wants. Trying to impose what the Minister, the Department or the Kildare and Wicklow ETB believes is right for the community might not work. The community wants to stay unified, not be divided. We want one school for one town. This simple philosophy has worked for a number of years. I have worked in the school and have seen at first hand how well it runs and integrates the community. The Department is trying to split the town. Instead of a well run, integrated community, it will be divided.

I appeal to the Minister of State to consider the Maynooth schools group's suggestions on an amalgamation and to revert with a concrete, positive answer with which we can proceed. I will stand before the appeals board next week regarding parents who cannot attend the Maynooth post-primary school even though their children's siblings already attend it, which seems strange. I appeal to the Minister of State to consider the amalgamation process, discuss the matter with the Maynooth schools group and propose a positive suggestion.

Many times in the past two and a half years, some of our colleagues expressed a wish in the Chamber to the effect that we would seek to have our children educated in schools that kept numbers at a reasonable level. In my estimation, any parent who was asked whether he or she wanted his or her child to attend a school of 1,000 pupils or a school of 2,000 pupils would give a resounding response in favour of the smaller school.

I regularly attend meetings of parents and school management bodies across the country. An opinion is emerging, one that is backed up by national and international research, to the effect that the optimum number of school enrolments is approximately 1,000 pupils. This figure affords significant economies of scale. It also creates an environment in which the principal and other members of a school's management body can retain some knowledge of each pupil's progress, be it positive or negative. The 1,000-pupil limit enhances the school's overall efficacy and adds to students' positive mental health and overall experience.

The optimum figure of 1,000 pupils has not been arrived at in a casual way. It has been considered by the Department and others in the education field. It is the reason that we want to allow for the development of two vertical schools of 1,000 pupils each on the same campus. There was never any intention to divide the community or to put one element in competition with another. The Minister has established a forum and an overall governance structure, which will work well and will build, rather than detract from, the community spirit. There will be two state-of-the-art modern schools with every facility one would require on a single community education campus.

The Deputy referred to the symbolism of the students wearing the same uniform. If it is the symbolic gesture that is required to sustain a sense of community in Maynooth, it can be discussed with the ETB locally and progressed.

Nursing Homes Support Scheme Applications

I thank the Ceann Comhairle for the opportunity to raise this Topical Issue. It relates to the fair deal nursing home scheme and the treatment of farmland assets within the context of the formula for calculating liability. Some 80% of assessable income - pensions, other forms of liquid income, etc. - is factored into the equation, as is a maximum of 7.5% of any asset such as farmland or dwellings. A disregard for an individual is €36,000 or €72,000 for a couple.

My query is based on a particular circumstance in my constituency. An applicant was a recipient under the early retirement from farming scheme and, having gone through that phase, is now in receipt of the old age pension. There is a three-year cap on the family home. Under the regulations, a three-year cap may be placed on land assets in certain circumstances. In this case, I understand that the applicant has opted for the ancillary loan facility from the State. The farm is small to medium-sized and the mix of enterprise is such that the cashflow and general income position is not what it might be in another enterprise. Hence, repaying at a later stage or even meeting the ongoing annual commitments had the person gone down that road would have been significantly problematic.

The lady in question, who had suffered a stroke, and her husband leased the farmland to their eldest son, who was actively farming it. They were in receipt of the early retirement from farming payment.

They have gone through that phase and are now on the State pension payment. In those circumstances will they be eligible to apply to apply for the three year cap on the farmland assets? It is not clear, and the phrase "may in certain circumstances" is not very definitive. The Minister of State might not be in a position to provide a definitive reply, but I hope he is. If not, he might refer to me afterwards. It is a genuine case and the circumstances are quite dire. There might be other similar circumstances coming down the tracks that could prove problematic for the fair deal nursing homes scheme in general.

I thank Deputy Kirk for raising this issue. Under the nursing homes support scheme, individuals contribute up to 80% of their assessable income and a maximum of 7.5% of the value of any assets per annum towards their cost of care, as the Deputy mentioned. The first €36,000 of an individual's assets, or €72,000 in the case of a couple, is not counted in the financial assessment.

An individual's principal residence is only included in the financial assessment for the first three years of their time in care. This is known as the three year cap. The three year cap also extends to farms in circumstances where all three of the following criteria are met in an individual case: the person has suffered a sudden illness or disability which causes them to need long-term nursing home care; the person or their partner was actively engaged in the daily management of the farm up until the time of the sudden illness or disability; and a family successor certifies that he or she will continue the management of the farm. In the case of couples, the measure applies where the applicant suffered a sudden and unforeseen illness and either or both members of the couple have been engaged in the running of the family farm. This stipulation is in keeping with the key principle of joint assessment of couples.

The three year cap was extended to farms because there was concern about the potential impact of the scheme on the sustainability of family farms, particularly in situations where care is required from an early age and for a prolonged period. It was intended to ensure the financial sustainability of farms in cases where a person suffered a sudden illness and did not have an opportunity to put appropriate succession arrangements in place. It affords additional protection because it ensures a person's maximum contribution is fully quantifiable.

The Deputy will be aware that the nursing homes support scheme is the subject of a review which will consider the long-term sustainability of the scheme as well as looking at related aspects of home and community care. Work on the review is ongoing. It is expected that the review will be completed in early 2014 and the report will then be made publicly available.

In 2012, a special allocation of €35m and 414 additional posts were provided for mental health to be used primarily to further strengthen Community Mental Health Teams in both adult and children's mental health services, to advance activities in the area of suicide prevention, to initiate the provision of psychological and counselling services in primary care, specifically for people with mental health problems and to facilitate the re-location of mental health service users from institutional care to more independent living arrangements in their communities, in line with A Vision for Change.

Budgetary pressures generally within the HSE delayed the full utilisation of the €35 million allocated in Budget 2012 for the development of community mental heath services. However this sum was available again in 2013, together with a further additional €35 million provided in Budget 2013, for the continued development of mental health services across a range of headings, including the further development of forensic services and community mental health teams for adults, children, older persons and mental health intellectual disability. The 2013 allocation provided for the recruitment of 477 additional staff to implement these measures. In addition, to ensure best use of the additional ring-fenced funding for both 2012 and 2013 the HSE carried out a comprehensive business planning process for the new posts envisaged for those allocations. This was completed by mid-2013 and enabled recruitment to move forward.

Recruitment of the posts approved for both 2012 and 2013 is continuing. As at the end of November, 2013 the recruitment process is complete or in the final stages for 394 or 95% of the 414 posts approved in 2012. Of the posts approved in 2013, the recruitment process is complete for 137.5 or 29% of the posts, 134.5 or 28% have been accepted and are being processed for clearance and 165 or 35% are at earlier stages of the recruitment or HR process. The posts related to the €35 million allocated in 2013 will continue to come on stream and are targeted to be completed in Quarter 2 of 2014.

There are, however, a number of posts for which there are difficulties in identifying suitable candidates due to factors including availability of qualified candidates and geographic location. The HSE's National Recruitment Service is currently working to ensure that the remaining posts will be filled as soon as possible, from existing panels or through competition in the absence of panels, at the earliest opportunity. Options to enable more local recruitment are also being considered where this will assist in filling specific posts. I have received assurances from the HSE that the recruitment process for these posts is being given priority within the HSE.

The Deputy will appreciate that even if I had all the details before me, it would not be appropriate or possible to address an individual case on the floor of the Chamber. I was trying to match up the circumstances related by the Deputy to the criteria set out here as best I could and I came to the same general conclusion as the Deputy in respect of the second point. I am willing to assist Deputy Kirk in this regard to see if we can nail the situation in respect of the query he made. We can address that either in correspondence or if the Deputy wishes to ask me to pursue it, I will be happy to do that.

Medical Card Eligibility

I thank the Minister of State for attending to reply to this issue, which is medical cards for children with Down's syndrome. I must declare a vested interest in this matter. I am a parent who has a daughter with Down's syndrome who, incidentally, has a medical card. I am also a former chairperson and former treasurer of the Dublin branch of Down Syndrome Ireland.

Today, I wish to highlight the children with Down's syndrome who do not have a medical card. What is going on here and why are some children with Down's syndrome included in this scheme while others are excluded? Almost 100 children with Down's syndrome have lost their discretionary medical cards in the last year. The survey carried out by Down Syndrome Ireland showed that many lost their cards despite having various conditions which leave them with very big medical bills. Half of all people with Down's syndrome are born with a heart defect. There are also gastrointestinal conditions commonly associated with Down's syndrome, as are certain types of hearing loss, cancer, cervical spine instability and visual impairment. Most children with Down's syndrome attend weekly speech and language therapy sessions as well, a cost which doubles with the loss of medical cards. Weekly occupational therapy sessions also cost approximately €50 each. Many parents of children with Down's syndrome are also obliged to visit a general practitioner almost weekly to manage their children's medical conditions. This usually costs approximately €65 each visit.

That is the reality for these families and children. Each year approximately 120 children are born in Ireland with Down's syndrome. There are 2,000 children under 16 years of age with the condition, so approximately 1,000 children are at risk and many of them are concerned. Will the Minister of State support these children and their families who are at risk of losing their discretionary medical cards? Will the Minister of State accept the basic principle that all children with Down's syndrome and all children with a recognised disability should have a medical card? Let the Minister of State start his vision of a universal health service today, and start it with these children.

I urge the Minister of State not to make parents jump through hoops. They have enough problems in their lives dealing with these issues. I encountered an example today when a family with a case of very severe physical and intellectual disability contacted me. They have to fight, beg and scream to get their medical card back. This is not acceptable in 2014. Many Government backbenchers share my concerns. Children from Dublin, Cork and Limerick have taken major hits in recent weeks. The Minister must listen to the voices of the parents and advocates of children with Down's syndrome. There are additional costs on doctors as well in respect of fees and prescriptions.

A total of 150 parents have already contacted Down Syndrome Ireland on this issue and appeals are ongoing. On the broader issue, how many of the recent 6,324 discretionary medical cards that were withdrawn were taken from children with Down's syndrome? I ask the Minister of State to support the provision of medical cards to all children with Down's syndrome, as well as other children with disabilities, as a start in implementing his vision of a universal health service.

I thank Deputy McGrath for raising this issue. Recent reports have stated that approximately 1,000 children with Down's syndrome - the Deputy said 100 but that might have been a mistake on his part or perhaps he was referring to a different report - have lost their medical card. I assure the Deputy that there is no policy or practice, in the context of medical card renewals, to target children or adults who have Down's syndrome.

The primary care reimbursement service, PCRS, which now processes all medical card applications and renewals, does not have any indicator on its clients registers that would identify people with Down's syndrome. That is the reason it is simply not possible to answer one of the Deputy's questions, which was how many people with Down's syndrome had lost their medical card in the last period. It is impossible to ascertain that. The way the records are kept in the PCRS does not categorise applicants in accordance with their medical condition. Even if the PCRS or the HSE wished to target people with particular illnesses or conditions for the removal of the medical card, they would be unable to do so. I can arrange for a briefing for the Deputy in this regard because this is something I was very anxious to ensure I understood. In fact, I was at the PCRS in Finglas a few days ago for a general meeting and briefing.

The applicants and those who have whole medical cards are not categorised in the system in accordance with their illness or condition. Even if somebody wanted to target people with particular conditions, which would be perverse, they could not do so because the system is not set up in a way that categorises people in accordance with a particular illness or condition.

I might add that this situation obtains to other medical conditions, including diseases and disabilities. There is no system in place that would enable people with particular disabilities or diseases to be targeted for review or discontinuation of medical card eligibility. The reason for that is that medical cards are provided to persons who, in accordance with the provisions of the Health Act 1970, as amended, are in the opinion of the HSE unable without undue hardship to arrange GP services for themselves and their dependants. Therefore the 1970 Act established a financial means assessment. The legislation has been in place for over 40 years. No Minister can override that decision of the Oireachtas that medical cards are essentially issued on the basis of financial means. They are issued to people on the basis that if they did not have a medical card they would suffer undue hardship in arranging for GP services for themselves or their dependants. That is the law under the Health Act 1970. The only way the situation can be changed would be for the legislation to be changed.

The Deputy will be aware that under the legislation, since 1991, the assessment for a medical card is determined primarily by reference to the means, including the income and reasonable expenditure, of the applicant and his or her partner and dependants. In the case of a child, the parents' income and reasonable expenditure is assessed. Under the legislation, determination of eligibility for a medical card is the responsibility of the HSE.

The HSE has produced national assessment guidelines to provide a clear framework to assist in the making of reasonable, consistent and equitable decisions when assessing an applicant for the general medical services or GMS scheme. These guidelines are publicly available and can be downloaded from the HSE's medical card website. They include the net after-tax, after-expenses income guidelines for the awarding of medical cards.

While there is no automatic entitlement to a medical card for persons with specific illnesses or with a disability, the HSE has discretion to award a medical card to avoid undue hardship, having regard to a person's or family's overall financial situation, even where the person's income exceeds the income guidelines. It is important to correct any impression circulating that medical cards are issued automatically or irrespective of means, even if an applicant is suffering from a serious medical condition. The Deputy will be aware that the GMS scheme is a means-based scheme, rather than one based on having a specific illness, as a reading of the legislation makes clear.

The HSE has established a panel of community medical officers to assist in the processing of applications for medical cards on a discretionary basis, where the income guidelines are exceeded but where there are difficult personal circumstances, such as an illness or physical disability which would impact on the applicant's financial situation.

I see my time has run out but perhaps I can return to this later.

When I referred earlier to about 100 children I was talking about one particular survey that was done. However, I agree with the Minister of State that the broader national figure would be in the region of 1,000 children with Down's syndrome who are at risk of losing their medical cards.

We must re-examine the categorisation issue and the system that has been set up. I take the Minister of State's point on the legislation but we must ensure that legislation protects the rights of children and adults with disabilities. I am concerned that we are taking our eye off the ball as regards how the 1970 Act deals with a person's financial means.

I am also concerned that the Minister of State does not seem to agree with the principle that a child with Down's syndrome or another recognised disability should have the right to a medical card. There are severe personal situations such as, for example, the cases I have to hand. One case concerns an eight year old who has Down's syndrome, asthma, sight difficulties, thyroid problems and hearing loss. His discretionary medical card was withdrawn in recent months. That is wrong, regardless of who may have made the decision.

Another case concerns an eight year old girl who was granted a discretionary medical card at the age of five. She has asthma, juvenile arthritis, a heart condition and hearing problems. In 2013, the HSE wrote to the family about its plan to withdraw the young girl's card.

I am asking the Minister of State to talk to his colleagues, the Minister of State, Deputy Kathleen Lynch, and the Minister, Deputy Reilly, about this matter. Earlier today I submitted the details of a case to the Minister's office concerning a young person with a severe physical and intellectual disability. The family is very upset about the loss of that person's medical card.

The Deputy mentioned the survey and whether the figure was 100 or 1,000 but I was referring to reports I had seen in recent days of 1,000.

I am not saying that there are 1,000 children concerned but I have seen those reports. I am not seeking to argue with the Deputy about numbers but I do not know what are the statistics. I am not being in the least bit facetious with the Deputy but it is not possible for me to establish the numbers, formally or otherwise, because the system does not include such information.

The Deputy seeks to urge me to accept the principle that somebody with Down's syndrome should automatically have a medical card, but the 1970 Act does not provide for that. I am interested in universal access to health care and, in the first instance, to GP services. That is what the Government is doing as regards the interim roll-out in respect of under six year olds. That is not a stand-alone project, it is the first instalment of a project in the programme for Government.

Which I support.

The Government is committed to extending universal access to the whole population within the lifetime of this Government. That is not the full medical card because, as the Deputy will say, there are other services as well. In recent days, the Minister for Health acknowledged that there are other services to which many people need access that they do not have with a GP-only card but would have with a full card. We may need to examine innovative ways of ensuring that those kinds of services are available to people who need them, without necessarily doing so through the full medical card system.

I am in favour of the universality system but I cannot override the 1970 Health Act. Neither the Minister, Deputy Reilly nor I, nor anybody else can extend medical cards to people other than in accordance with the law. The law refers to "undue hardship" which can only be ascertained through an assessment of financial means, with the extra discretionary effect where somebody's condition or illness is affecting their financial situation. That is the position.

I understand the case the Deputy is making and I appreciate his support for the universality principle. We have some distance to go on this but the more support we have across the board politically, and in the broader society, for universal access to GP services the better.

The Dáil adjourned at 5.30 p.m. until 2 p.m. on Tuesday, 21 January 2014.