asked the Minister for Health if he will make medical cards available as of right to all handicapped and disabled people.

Under the Health Act, 1970, an adult person is entitled to a medical card if, in the opinion of the chief executive officer of the health board, it would be an undue hardship on him to provide general practitioner service for himself and his dependants. If the degree of handicap or disability results in such hardship the person is already eligible for a medical card, and may qualify for further assistance.

Persons suffering from prescribed long-term diseases and disabilities, but who do not qualify for medical cards, can obtain drugs, medicines and appliances free of charge.

Where the presence of handicap or disability is made known to a health board, account will be taken of this in assessing an application for a medical card.

In these circumstances I do not propose to accede to the Deputy's request.

Would the Minister ask the health board to give special consideration and not to apply the terms too rigidly? I know there is provision for this but in the case of the handicapped and disabled there should be a greater degree of flexibility.

I accept what the Deputy says. We have done this in other cases and I will do it once again.

Is there a definition of a "disabled person" for the purpose of issuing medical cards?

If they come within the eligibility for particular cover, they are defined in that sense. The Deputy is raising the question of people who do not come within that term and this is obviously more difficult to define. I will raise the matter with the health boards.

4.

asked the Minister for Health if he will extend the medical card scheme to all children suffering from asthma.

I do not propose to extend the medical card scheme to children suffering from asthma. As the Deputy knows, the parents of such children can obtain a refund of part of the cost of medicines prescribed for them. Receipt and claim forms for this purpose are available from retail pharmacies.

A major problem with asthmatic cases is the need for medical examination and treatment, not necessarily drugs. In view of the fact that people have to travel such long distances to obtain treatment, particularly if they live in rural areas, and because it is such a disabling condition, would the Minister consider including it in the list of prescribed illnesses?

Each year the list of prescribed illnesses is reviewed and in general terms I accept what the Deputy says. One would like to see the scheme extended as far as possible. There are two problems, one of which is the question of definition in relation to a disease like asthma, and the other is the question of cost. If it can be possible to define particular categories within that area, I shall certainly bring those categories up for further revision.

Would the Minister consider consultations with the medical profession with a view to a definition of asthma in children, where there is no danger of equivocation about the nature of the illness? In situations where children are concerned, would he consider undertaking, or have his Department undertaken, any survey into the cost of including asthmatic children in the free drug scheme?

(Cavan-Monaghan): Might I ask the Minister whether asthma has been scheduled as a long-term illness? There is a schedule of long-term illnesses.

No, it has not. That is where the problem arises.

(Cavan-Monaghan): Is that not an extraordinary state of affairs? Does the Minister not agree with me that, looking at it from a layman's point of view asthma seems to be a lifelong illness? We have always understood it was a long life and a troublesome one which was involved for asthmatics. I ask the Minister to reconsider the matter and to schedule asthma as a long-term illness.

As I said to Deputy O'Connell previously, I agree in general. There are, however, very large numbers involved.

(Cavan-Monaghan): There are.

The estimate of the incidence of asthma is 175,000. The Deputy can thus appreciate the cost factors which arise in that situation. Nevertheless I sympathise with the problems in general and this is why I told Deputy O'Connell that if we can find definitions which bring out the worst and most clearly defined situation, then I would be prepared to take this matter up and, as Deputy O'Connell has requested, I would certainly have discussions in relation to it.

(Cavan-Monaghan): Would the Minister not agree that the large number which he has just mentioned would seem to make a better case for scheduling asthma as a special illness?

This is a specialist argument.

Except that it causes considerable difficulties in relation to costs.

Is the Minister saying that the high incidence of the disease could be a deterrent to taking action to relieve the problem?

That is an interpretation. We have been a long time on this question.

I am just asking the Minister if this is true.

I have already said that there are two factors, one is the definition and the other is the large number of cases.

Question No. 5 has gone for written answer.