There is no provision by which the Disabled Drivers Medical Board of Appeal can issue a primary medical certificate without reviewing the appellant although s/he can reapply locally after six months from the date of the first review with medical evidence of a deterioration in his/ her condition. I understand from the Chairperson of the Medical Board of Appeal, (which is independent in the exercise of its functions), that clinics are normally held in Dublin and 30 people are generally invited to attend for assessment at a clinic. From time to time, people appealing a decision not to grant them a Primary Medical Certificate decline an assessment in Dublin. When sufficient numbers warrant it, a clinic is held outside Dublin.