asked the Minister for Health the action he proposes to take to relieve the hardship suffered by those people who failed marginally to qualify for medical cards at the last review in 1975 and as a result of the cancellation of the routine review in July, 1976, are still outside the scope of the scheme.

The statutory criterion for eligibility for a medical card is inability to provide general practitioner services without hardship. A person whose income is marginally outside the guidelines is not necessarily ineligible. I would mention that the total number covered by medical cards, which was 1,162,386 at the end of 1975, is now 1,183,903.

Is the Minister aware that the routine six-monthly review which is carried out into eligibility for medical cards was due to be held in July and did not take place? Is he aware that that review takes cognisance of the consumer price index and as there was a substantial increase in the index, if that review had taken place many more people would have qualified for medical cards.

A brief question, please.

I am not aware whether the latter part of the Deputy's statement is correct. I do not think the Deputy has any need to complain in regard to the cover for people under the general medical service. I went to the trouble of finding out the figures for Monaghan—the Deputy must be interested primarily in his own county —and I discovered that from 1st January, 1973, the number of cards issued was 7,811, and on 30th September this year it was 13,134. On 1st January, 1973, there were 15,695 holders of medical cards, that is, 33.9 of the population. On 30th September this year the number of people covered was 26,112, which represents 56.7 per cent of the population. That is a very steep increase.

Is the Minister aware that the routine review which should have taken place in July did not take place and that the consumer price index had increased considerably since the previous review last December?

That is a matter for the CEOs. They did not carry out the review, and I have no power to direct them to do so.

Will the Minister assure us that the review will take place in January? He knows himself that the present guidelines are completely unrealistic. Again on the question of the number of people holding medical cards, surely the Minister is aware that the reason for the increase is not the ordinary families but the number of young people unemployed who immediately they leave school get medical cards? The cards have been taken from the families wholesale because the guidelines are completely out of touch with the situation.

The number of unemployed is a factor, I admit but——

It is the big factor.

——but these guidelines are, as they are described, guidelines. If there is somebody marginally above it and he is deemed as head of the family not to be able to provide for the services that would normally be provided under the GNS, he could qualify for a medical card. It does not necessarily mean that because somebody's income exceeds what is described as the guidelines by say, 50p, 10p or something like that, he is excluded. If in the judgment of the CEO, despite the guidelines, this person cannot provide these services for himself and his family, he is by law entitled to a medical card.

Would the Minister recommend to the health boards what he has just told us, that if a person is marginally over he will not be automatically ruled out? I have experience of the guidelines being rigidly adhered to with no flexibility whatsoever. May I suggest that the Minister should get in touch with the CEO——

Can the Minister assure us there will be a review in January?

That will be a matter for the CEO.

I thought the guidelines were uniform all over the country?

They are uniform, and in any review I am sure they will come up with guidelines——

Will the Minister insist that there is a review in January, seeing that the guidelines are completely unrealistic?

We are having repetition. A final supplementary from the Deputy.

I want an answer to that.

The Deputy may not impose himself on the House.

I have already explained that I cannot direct the CEO. The normal practice has been to have this review——

But it has not taken place.

——as distinct from four or five years ago when a review was carried out only every four or five years.

Will the Minister not accept that the CEOs and the health boards cannot go ahead with the reviews because they are all broke?

The usual cod from the Deputy.

A lot of rubbish. If the Deputy were a member of a health board he would not be saying what he is saying here today.

I am a member of the Eastern Health Board——

That is exactly what I wanted the Deputy to say. It is the Eastern Health Board that has gone mad while all the other boards are running on sane lines.