asked the Minister for Health the number of students at third level education who have been removed from the general medical services register from 1 January, 1984.

3.

asked the Minister for Health the number of third level students who have been removed from the general medical services register in the constituency of Dún Laoghaire from 1 January, 1984.

4.

asked the Minister for Health the number of students in County Donegal that have been removed from the general medicine services register as a result of his recent action.

5.

asked the Minister for Health the number of students in County Kerry who were removed from the general medical services register from 1 January 1984.

I propose to take Questions Nos. 2, 3, 4 and 5 together.

Arrangements are being made by the health boards to implement the provisions of the Health Services (No. 3) Regulations, 1983. This involves writing to all medical card holders in the 16 to 25 years age group informing them of the provisions of these regulations.

An opportunity is being given to claim exemption where the regulations do not apply. Until such time as those arrangements are implemented in each area, students from that area are not being removed from the general medical services register by virtue of the regulations.

The information which the Deputies are seeking would tend to vary from day to day as health boards proceed with the task of implementing the regulations. The total number of students removed from the GMS register in any area at any time is not available routinely in my Department. I suggest that the Deputies get in touch with the appropriate health boards in order to get the most up-to-date statistical information that is available on this matter.

In view of the serious problems created by the removal of medical cards from those between the ages of 16 and 25 and in view of the fact that a number of students are now in prison, would the Minister consider suspending the regulations and reconsidering the matter?

I regret that I am not in a position to accede to that request.

Would the Minister not accept that the students are very concerned about the hardship this change would create and in these circumstances would he not reconsider the situation?

I would not accept that generally there is hardship being created. On average, students use the general medical service for the purpose of visiting GPs about twice a year and for two to three prescriptions per year. That level of usage has been long-established. The only thing that is being withdrawn by way of automatic entitlement without charge is access to a GP or to drugs. For the umpteenth time I would stress that hospital services, inpatient and out-patient, and consultant services are not being withdrawn under the regulations. I repeat again that any student who informs a health board that he or she is suffering a degree of hardship will not have the medical card withdrawn. That is the position. Automatic entitlement is being withdrawn.

If the students have been making so light a demand on the health services, will the Minister not accept that it was not worth his while establishing a whole administrative process to assess their eligibility for a medical card?

The administrative process is not complex. Yesterday I was in the headquarters of the North Western Health Board — Deputy Gallagher's area. By means of a simple computer print-out and the automatic issuing of forms the whole business is done in a matter of a day. I will point out to Deputy Gallagher who has put down a question on the matter that to date no medical card has been withdrawn. Further, I would point out to him that since 62 per cent of the population of his county have medical cards, by and large 62 per cent of students will retain the cards.

Does the Minister not understand and appreciate that he has condemned himself out of his own mouth? In his last replies he has made the case for not bringing in the regulation which has alienated the student population.

The Deputy will recall being a member of the Cabinet who proposed this measure but who did not implement it.

That is untrue. The Minister had better answer my question without those smark aleck tactics.

Order. The Chair will decide about such matters.

Arising from that comment of the Minister——

I will not allow argument on this matter.

The Minister has considered himself free to disclose matters that were considered as distinct from matters on which decisions were made. A decision was not taken.

The Deputy was not a member of the Cabinet.

What the Minister has said is outrageous.

Deputy O'Kennedy is being disorderly. He should allow the Minister to answer.

By comparison with the way the Minister replied——

We must have order. The Minister was asked a supplementary question and he answered it.

He has not answered it, that is the point.

He was not allowed.

I am asking the Minister to answer the question and not engage in smart aleck remarks. We are used to enough of that from this Minister.

Deputy Lenihan must cease interrupting.

We will be indulgent to the Chair in view of the day. I offer the Chair congratulations on his birthday.

I thank the Deputy. I am calling Question No.6.

Before we move to the next question I should like to ask the Minister another question with regard to students. In deciding to withdraw medical cards from students, did he take into account the dramatic increase in fees for third level education that was introduced by his colleague?

I wish to point out to the Deputy, and I take no great pleasure in it, that there is major State subsidisation for students in second and third level education. There will be a saving to the health services of approximately £2,500,000 per annum by no longer giving automatic entitlement to second and third level students irrespective of income. Approximately 120,000 students are involved. However, more than 40,000 students, by virtue of the fact that their parents' incomes are below the limits of income eligibility for medical cards, will automatically retain their entitlement. I find it incredible that Deputies on the opposite side should suggest that people in the upper income group who are quite wealthy and whose children are in third level education should automatically be given entitlement to free access to GPs and to drugs. The cost on average is about £30 per year: two consultaions to a GP and about two attendances to a pharmacist to get drugs. The total cost on average is between £25 and £30 and for 80,000 people we will save approximately £2,500,000 in a full year. Despite all the special pleading by the Opposition with regard to this matter, I reiterate that this measure was included in the Government memorandum of June 1982 and was approved by the then Government for implementation. However, Deputy Woods and Deputy Haughey ran away from it.

That is not true.

The Minister was allowed to make a speech but he has not answered the question. I am asking the Minister if, in calculating eligibility for medical cards, he will allow the parents of the students to take into account the dramatic increase in third level fees.

I suggest that parents might take into account that in relation to family medical expenditure there is full income tax relief on expenditure in excess of £100 per annum. In relation to covering their dependants for VHI, there is full income tax relief at the top tax rate and in relation to the attendance of their children in second and third level institutions there is a substantial tax allowance available. My son who is in third level education has lost his medical card and this should apply also to students whose family are in the upper income group.

I wish to state——

I have been very generous with the Deputy.

The Chair has allowed the Minister to make a very lengthy speech when he could have said yes or no at the beginning.

The Minister should be removed from the House.

The Chair may have a different style of answering questions compared with that of a Minister. However, the answering of questions is not a matter for the Chair. Deputy Tunney well knows this and I am surprised at him raising the matter.

The Minister made a speech.

Will the Minister not agree that the vast majority of students who will be affected by this regulation are children of middle-class parents, not of the upper income group. The vast majority of students in third level colleges belong to the middle income group. This will impose a very severe hardship on the parents. They are the new poor.

For the benefit of Deputy O'Keeffe, I would point out that the Chair has discretion and a control over the asking of questions but not with regard to the answering of questions.

By way of elaborating on what Deputy McCarthy has said——

This just shows how far away we are getting from the question.

Is the Minister telling us that all those who are above the limit for medical cards are in the upper income group?

When referring to his visit to the Donegal — Sligo — Leitrim headquarters yesterday, did the Minister say in his reply that all children in the North-Western Health Board region who held medical cards prior to 1 January can continue to use those cards? Is he saying that a man with seven children, with £150 top line is in line for a medical card, but men with six children, five children, or four children with £140 top line are not eligible? Are these the rich people the Minister is talking about, because they are some of the people I represent? If we had 100 per cent medical cards for the people in Donegal-Sligo -Leitrim I would not be ashamed to stand here——

(Dún Laoghaire): We are implementing Fianna Fáil policies.

The Deputy is behaving like a child. He is going too far.

Question No. 6.

May I have an answer?

Six out of ten families in Donegal have medical cards and automatically their children have medical cards and cover. That cover is not being taken from them. They can continue to use their cards. They will get a notification and all they have to do is return the number of their parents' medical cards and they will continue to have automatic cover. There will be no difficulty.

The Minister stated——

I have been more than generous. We have been at these questions for 20 minutes.

It would be very unfair if this went out from this House: The Minister stated, and the record will show, that anyone in the north-west region who held a medical card prior to 1 January will not have his card taken from him. I wanted to get that on the record.

Question No. 6.

6.