I refer to page 57 of the programme for Government, which deals with medical cards. The Taoiseach must listen to and understand what I have to say. The parents of a child who is waiting for a prosthesis have been refused a medical card. A man who has been on a waiting list for a kidney transplant for three years was refused a medical card. A person suffering from cancer is waiting for a medical card.

I follow this issue very closely and I make this point with the utmost respect, as do other Members who are tuned into the issue of medical cards. Within the past 25 days, for some reason or another, the criteria of the medical deciding officers in the PCRS unit have changed. They have stopped issuing medical cards on discretionary grounds. Why has this happened? There are far more experienced Members in the House, such as Deputy Ferris, who have been here a lot longer than me.

A question, please. You have made your point.

Why has a change happened in the past 25 days? Who pushed the button? Who told officers to stop issuing discretionary medical cards? As I said, people who have far more experience than me realise this is happening.

It is in the programme for Government.

Page 57 of the programme for Government refers to medical cards. We put it in there to ensure discretionary medical cards would continue to be issued.

Taoiseach, who pushed the button?

Deputy Healy-Rae understates himself when he says there are far more experienced people than him in the House. I can assure the Deputy that there has been no change of policy in the Department of Health or the HSE in respect of discretionary medical cards. Given that the Deputy deals with such a volume of inquiries about medical cards, it may well be the case that a number have come through with particular difficulties. I do not know the details of the child who requires a prosthesis, the person who is waiting for a kidney transplant or the cancer patient to whom the Deputy referred. Let me assure him that what he put in here stands. The is no change of policy in respect of discretionary medical cards. Perhaps he could forward the details of the cases he has and it could be demonstrated whether that is so.

I refer to medical cards. Last Thursday I raised an issue on the Order of Business. We fought with the Department and HSE to resolve the issue over the weekend. A letter was sent by a consultant to a patient stating that the patient was terminally ill. A letter was sent by a GP outlining the extent of the cancer from which the patient was suffering. The medical card section refused to accept the letter and sent an e-mail seeking clarification on whether the patient was receiving end-of-life treatment.

I asked the HSE on a number of occasions on Thursday and Friday what part of "terminally ill" it did not understand. There is an issue. What happened over the weekend in regard to the patient to whom I referred was disgusting. The matter has been resolved and I thank those who helped to resolve it, but something has happened with regard to the issuing of discretionary medical cards. Consultants do not refer to end-of-life treatment on application forms or letters for obvious reasons.

The Taoiseach said there had been no change in policy. I would like to bring to his attention an issue that I am dealing with. A 99-year-old woman is being cared for at home by her son, who is an old age pensioner, and another family member who lives nearby. She is incontinent and previously received, through her medical card provision, a supply of nappies. Under a new policy it was decided that her supply of nappies would be cut by 50%. How can any Government justify that? She is living at home and saving the State a fortune. There has been a change in policy.

Consultants usually only write letters to point out a deterioration in the circumstances of patients or when there is a requirement for a card to be issued. They are called discretionary medical cards because discretion can be applied, even if only for a short time. I do not know the individual or official who made the decision to which the Deputy referred, but it seems to be extraordinary for a senior citizen of such venerable years. It is not good enough. I ask him to bring it to the attention of the Minister for Health. It is not acceptable.