The Minister for Finance, Deputy Noonan, announced here yesterday evening that some people who have lost their discretionary medical cards will now have them returned. It is still not clear whether all people will have them returned and the process for return has not been clarified. This is a particularly dramatic U-turn for this Government, particularly when its members all spent 18 months denying that a cull was under way. I notice the Minister, Deputy James Reilly, was not in the House when the announcement was made and he is not here now. However, since the announcement was made, there still continues to be Government disarray on the issue. The Minister of State, Deputy Alex White, who told us a few weeks ago that there was no such thing as a discretionary medical card, has said it is a collective Cabinet responsibility, for which he had no part, and now we read reports in all of today's newspapers regarding last night's Fine Gael Parliamentary Party meeting where the Minister, Deputy Reilly, told the meeting that the handling of medical cards was a disaster. He further told those present that he sought repeatedly to address the medical card issue but apparently the political will from his Cabinet colleagues was not there until last week. We now have the Minister, Deputy Reilly, and the Minister of State, Deputy White, who are the Laurel and Hardy of this Government, passing the buck rather than taking responsibility for the whole fiasco.

The fiasco is outlined in this morning's edition of The Irish Times in its coverage of the case of a family in Wicklow where a father has a rare cancer and a son has cerebral palsy and the family have been asked once again to resubmit documentation in regard to their medical card, a case that has been repeated hundreds, if not thousands, of times across the country as a direct result of the handling of this issue by the Minister, Deputy Reilly, and the Minister of State, Deputy White. This is only one case and the Minister and Minister of State are blaming someone else, and that someone else is the Minister, Deputy Howlin. All of the Fine Gael sources today are saying the lack of political will goes back to his desk and that he seems to be the person to whom the Minister, Deputy Reilly, is referring in regard to his inability to get buy-in to the solution of this problem.

A question please, Deputy.

Can the Minister outline his response to the suggestion, which has been made off the record, that he is the block to a resolution? Second, with this debacle in mind, and granted that he has an overseeing role in the Department of Health, can he express full confidence in the Minister, Deputy Reilly's ability to continue his job as Minister for Health?

The opening premise of the Deputy's question is wrong. There has been no cull or no intention of having a cull of medical cards.

What?

For God's sake.

It is ongoing.

Please, Deputies.

A Cheann Comhairle, that is hard to take.

The number of medical cards is at an all time high.

The stabilisers were put on-----

Quiet, please.

This is an extremely serious matter. At the end of last year, there was 1.849 million medical cards; 42% of the population have medical cards. There are more medical cards in circulation now than at any time in our history.

That is cold comfort.

I am a former Minister for Health. Every Administration has issued medical cards on the basis of the 1970 Act. It was done on a local basis determined by ability to meet medical costs. There was always a local discretion. Medical cards have been centralised in recent times. That was a decision made by the previous Administration that has been carried out. One of the things that has come to light in that is the variety in terms of the exercise of that discretion. For example, in Cork 70% over the national average in terms of medical cards were given and in Meath 70% under the national average were given. That is not equitable or fair. We need to have a system that takes account of real hardship, that is compassionate and that understands that such cases, and Deputy Calleary has instanced another one today, are unacceptable and that people who are faced with that sort of medical need should be assisted by the State. That is why the Cabinet has decided to develop a policy framework to determine eligibility in a fair and open way-----

When?

-----not on the basis of where one lives in the State, which has been the condition for the past number of decades, but on objective criteria. The criteria, however, must also be linked to some financial grounding because that is the basis of the 1970 Act, or we can have a broader debate about looking at how we can afford to ensure that everybody who is sick gets comprehensive medical care for free.

Sending all the applications to Cork seems to be a good solution.

That is an extraordinary response from the Minister. The Cabinet, according to the Minister, Deputy Noonan, had a long discussion on medical cards - as did all of the Members' parliamentary parties. Some 16,000 discretionary medical cards were cut from January 2013 to April 2014. That is a cull in any language. Those are discretionary cards taken from people in the case I described, taken from children with disabilities or families coping with serious illnesses and being asked to go through the rigamarole. Again, the Minister avoided the direct question I put to him. He has answered the other question because I judge from his attitude that he may be the block to some sort of justifiable resolution to this issue. Does he have confidence in the Minister, Deputy James Reilly's ability to continue as Minister for Health? A straight "Yes" or "No" answer will suffice; there is no need for a soliloquy.

A "Yes" or "No" answer now, Minister.

First, I have full confidence in the Minister, Deputy James Reilly, and every member of this Government and I have full confidence in every Minister of State to do the job, the most difficult, challenging job that faces us all. Every Department has been faced with very difficult economic decisions to make. This Government has worked as a collective-----

It does not look like it.

-----to solve the issues to bring us from a very difficult position to a position of solvency, which we have now arrived at. We have tried to do that and have done that in as compassionate and open a way as we can. Have we made mistakes? Yes, and I agree with Deputy Calleary that the handling in terms of the administration and some of the letters people got is unacceptable. It is unacceptable to every member of Government and we need to do better. If one looks at discretionary medical cards and the general review of medical cards, there is a normal turnover. One could instance thousands being changed. Out of 1.8 million, naturally people's circumstances change and there are people who losing medical cards and new people gaining them. What we have to do is to have an objective system that works wherever one lives in the country, that is compassionate and that takes account not only of financial means, but also of health criteria.

That is what we had before.

That is what is being developed now by the Department of Health and by the Minister for Health and he is going to come back to Government within the next fortnight with those criteria so that we can put in a rational, compassionate, national scheme that is not determined by where one lives in this country, but on the real medical demands upon every household.