asked the Minister for Health the revision, if any, that will be made in 1983 in the guidelines for the issue of medical cards; and if he will make a statement on the matter.

The guidelines for eligibility for medical cards are reviewed annually and revised, as necessary, with effect from 1 January to take account of changes in the cost of living during the previous 12 months. Such a revision has already taken place with effect from 1 January of this year. The guidelines will be reviewed again before the end of 1983. Any revision to be made at that stage will depend on changes in the cost of living during 1983.

Do I understand from the reply that there may be a change in the guidelines during 1983?

No. The guidelines will be reviewed again before the end of 1983. They will not be reviewed until the end of 1983, to be implemented by 1 January.

Will the Minister accept that there have been some fundamental changes in the use of medical cards since 1 January 1983 when the last guidelines were implemented? There is the use of the medical card for eligibility for school transport and there has been a tremendous increase in the cost to patients in respect of the drugs refund scheme under which patients are obliged to pay almost 100 per cent more than last year, £23 per month. This causes hardship for a number of people and therefore there is a legitimate reason why the guidelines should be looked at. Many people just above the guidelines are not in a position to meet their needs.

No matter what line you draw there will always be someone above the line who cannot manage. The review resulted in a 12.3 per cent increase from 1 January last based on the CPI from mid-November 1981 to mid-November 1982. That was a reasonable increase in the circumstances.

Do I understand the Minister to tell us that he accepts that a couple in advanced years with an income of £77 a week are capable of paying for their total medical expenses, doctors and prescriptions?

I did not say that.

But is that not the reality? That is the guideline. The situation is that from the first week in July two old age pensioners living together will not be entitled to a medical card if they have that income.

They will be if they have only that income.

If they have more than that they will not be entitled. With the miserable increase the Government have given in the budget they may be slightly in advance of £77. What will the Minister do to allow such people to hold medical cards?

The Deputy is making speeches.

I am making speeches on behalf of old people who are unable to make them for themselves.

The Deputy should take steps to have Standing Orders amended if he wants to make speeches at Question Time.

As the Minister responsible for social welfare beneficiaries, will he accept that it is not possible for people with that kind of income to provide for medical expenses?

The guidelines are long-established. They are being increased in the normal way as they were when the Deputy was on this side. For some reason he was not so vocal then. We must have guidelines. If we increase the income by another £5 people would still be coming to us asking if they were expected to live on that. A line must be drawn. I do not dispute that people are entitled to argue on it. The guideline in this respect was accepted by the Deputy when he was on this side.

Is £77 a suitable guideline? The Minister is shirking his responsibility.

I got the impression that the Minister said there is a possibility that the guidelines will be reviewed before 1 January next.

They will be reviewed towards the end of the year with a view to implementing them by 1 January. The health boards will then be informed before 1 January.

At present there is an annual review. Would the Minister revert to a half-yearly review?

Because of the constraints we have in regard to overall capital, and throughout the health board areas, one must weigh carefully any intention to have reviews other than once a year. The budget is presented on an annual basis and it is on that that we are able to make our recommendations.

Now that the Minister for Finance has his hands in the banks' kitty the Minister will have plenty of money.