On "The "Saturday Night Show" last Saturday, the people of the country would have watched Declan and Annette Coyle talk movingly about their nine year old son, Alex, and their heartbreak and sense of bewilderment at the heartless decision to take the discretionary medical card from their son. They put on the table the entire supply of medical equipment required for Alex on a weekly basis. It was a cocktail of syringes, feeding pumps, nappies and medication. With dignity and pride they spoke about how they look after their son on a 24 hour, seven days a week basis. He has Mowat-Wilson syndrome, which is very rare. If anything captured the extraordinary scandal that has been going on in our health system for the past two years, that episode captured it.

I have raised time and again with the Taoiseach the Government's decision to end discretionary medical cards and take them from very needy people. The Jack & Jill Children's Foundation has 300 such hard cases with very sick children, and its literature is now stating that the Government is torturing the parents of such children into submission. Is that what the Taoiseach and the Government is about? Since January 2012 I have raised case after case involving issues such as this one. It is scandalous, and it reflects badly on the Government's view of issues and its sense of priority.

There are other cases. An older woman with breast cancer and secondaries who is €20 over the limit has had her medical card withdrawn, as has a man suffering from chronic depression who previously attempted suicide and is €5 over the limit. The longest surviving Irish patient of chronic myeloid leukaemia, James Mullen, who has had a medical card for 22 years only found out during a visit six months ago to his chemist that it had not been renewed. What is going on is extraordinary.

The Taoiseach has denied that there was any change of policy. We now know, courtesy of the Minister of State, Deputy Alex White, that there was. He is now questioning whether there ever was a legal basis for discretionary medical cards. That anybody would do this to such vulnerable children and adults is causing uproar and shock across the country.

The Deputy is over time.

Will the Government intervene and change the policy and restore discretionary medical cards to young sick children like Alex Coyle and others who have had their cards wrongly withdrawn from them?

I did not see the show referred to by the Deputy and do not wish to comment on an individual case. Obviously, these are exceptionally sensitive cases. It should not be assumed that the Government is out to withdraw medical cards from people as a matter of policy. The Deputy is well aware that for many years community welfare officers from various parts of the country were in a position to make a judgment in regard to whether a card should or should not be allocated, which made for uneven allocation of cards. The centralisation of the process has resulted in a more even allocation across the board.

The Government made a mess of that.

In regard to the cases highlighted, the facilities, aids and appliances required by a sick child or adult are met by the long term illness scheme. The question that arises is how far can we stretch discretion given the equality of assessment that applies in terms of the income limits. I have been informed by the HSE that it has been flexible in dealing with individual cases. I accept that in centralising applications to one database cases can be missed and that the nature of the machine is that it does not recognise the circumstances in which people find themselves. I, too, have dealt with a number of these cases.

I understand that members of the family mentioned by the Deputy were in discussions about the matter today with personnel from the HSE. A series of presentations are being made regarding automatic qualification for a full medical card depending on the nature of a person's condition or circumstances. As the Deputy will be aware, the system provides for a full medical card, long term illness entitlement, a discretionary medical card and an emergency medical card. The problem that arises is if one decides to change the law in respect of particular categories, which may include people whose cases are very difficult to deal with, how far does one go? As I understand it, it is estimated an additional 250,000 people will be diagnosed diabetic in the next ten years.

I engaged early this morning with the HSE about these cases and will engage further on the matter tomorrow with medical personnel. I accept that the review process in the context of the sharing of information between the Revenue Commissioners, the Department of Health and the Department of Social Protection results in an assessment of approximately 80,000 cases per month. In this regard 30,000 people are never written to because it is clear they are entitled to a full card and 30,000 are asked to report on whether their conditions have changed and so on. Some of the remaining cases can be problematic. Nobody wants to see any child left without assistance.

It is being done.

It is happening.

While the long term illness scheme covers all aids and facilities, there are cases that need to be dealt with on an individual basis. I have undertaken to deal with this.

The case of Alex Coyle was described on the "Saturday Night Show" as barbaric. It is barbaric. During the show a photograph was shown of the young boy in intensive care following a seizure. Anybody who saw it would not have to think twice about what needs to be done. His medical card must be restored. I am surprised the Taoiseach has not picked up on the matter. People all over the country are posting messages about it. They are in shock at what has happened.

The Taoiseach was warned about this two years ago. It is clear that young and elderly people with chronic terminal conditions are being targeted in terms of withdrawal of their discretionary medical cards. Thousands of discretionary medical cards have been already withdrawn. Many times, I have given the Taoiseach lists of people whose cards have been withdrawn. This is not about another list, rather it is about the need for systemic change.

A question please.

It is about changing the policy of persistently and, in my view, heartlessly, withdrawing medical cards from those who need them most. I invite the Taoiseach to view the clip of the show about which I am speaking. I think it will change his mind.

Let us forget the red tape and forcing children to go through hoops and sort out this mess once and for all. Everybody here knows what is a medical card. Let us give back medical cards to the children who need them.

Hear, hear.

It is a simple request. The Taoiseach has the authority and the power to make this happen. No self respecting society would stand over this.

The Deputy has made his point.

In the worst of times the discretionary medical card, required by sick children and people with terminal illnesses, was always protected. That was the least we felt we could do. Given the scale of equipment and medicine required by the child concerned, there is no way his family can meet his needs. There is no way they can do it without a medical card.

Fine Gael and the Labour Party do not care.

I will not stand over a situation where children and young adults in need of State support do not get it. None of us wants to see that happen. As I understand it, the HSE in dealing with individual difficult cases has been more than flexible in terms of the income limits.

Rubbish.

Not at all.

I am speaking about cases of which I am aware.

It is different when a letter is received from the Taoiseach.

Please listen to the reply.

The question that arises is how far does one extend that flexibility. If one takes all of the children-----

I am speaking about those with rare syndromes.

Taking all of the children who have problems of one sort or another, be they physical, intellectual and so on, how does one ensure equality between one person with a particular medical circumstance and another? Where in this regard is the line to be drawn?

As I said earlier in my discussions with the HSE, when a system such as this is centralised and computerised the nature of it is lost because of the manner in which the machine selects cases for review. The challenge for the Minister and the Government is to have a system that is fair but takes into account these circumstances.

While I said earlier that I had not seen the programme referred to, that does not mean I am not aware of it. When I get an opportunity, I will, of course, look at it. I, too, have come across some really difficult cases, some of which were approved and others were not. There are cases in respect of which flexibility is required, even for people who have incomes in excess of the limits. Even where flexibility is applied, one can run into problems in terms of equality of treatment and the reason one person gets a card versus another.

I accept this is an issue. I also have been contacted by parents regarding sensitive and difficult cases. Nobody wants to see this happening. The question that arises is whether we can devise a system that caters for that in a way that is in compliance with the law that has been in place for some time. I am looking at that.