I want to raise the very important issue of medical cards. I have permission from an applicant to mention this case. I have written to the medical card processing unit on 11 occasions between 14 March and 10 June, contacted them by telephone on more than 15 occasions and asked two parliamentary questions of the Minister for Health with regard to the individual. The man developed encephalomyelitis, which is a general term for inflammation of the brain and spinal cord, in 2012. Since then, he has been left with a great number of neurological defects, which are proving impossible to manage. During this time, he has seen 22 consultants and attends the Santry Sports Clinic in Dublin weekly for treatment as this is the only place in the country that he can be treated. He needs regular botox injections to control the spasms and four times the normal amount of Lyrica to control the pain. As late as Wednesday, 15 June, he received 31 injections in his head. Another example of his condition is that if he was to run after his child in an emergency situation his rib cage would automatically go into spasm to protect his lungs and actually squeeze his lungs, restricting his breathing. He applied for a medical card on 19 January 2016 and was refused a card on 22 February 2016. His application was appealed and refused again on 5 May 2016. His case was then again reviewed by a senior medical officer and the decision was upheld on 8 June 2016.

This is one example of the many cases I have dealt with - I am only one politician in this House and we should think also of all the county councillors dealing with the issue of medical cards - where more than adequate medical information has been provided to entitle people to a medical card and time and again they are being refused. How could any right-thinking person have refused this individual his medical card?

With regard to the current waiting time for cataract operations, I must first compliment the staff in our hospitals providing this service as they are only operating within the resources that are available to them as the demand for the service is very high at the moment. However, I know of people in my constituency who have gone blind while waiting for cataract operations and this continues to happen.

I have been informed by the Minister for Health, Deputy Simon Harris, that as of 24 May 2016 in the south and south west hospital groups there are 461 people on the waiting list to be seen. The previous Minister for Health, Deputy Leo Varadkar, determined that the maximum waiting time should be 15 months but this is not happening as people have had to be taken off the list and are going blind because it has taken so long for their operations to be performed.

The details of the case described by the Deputy are very distressing. Greater discretion is being exercised by the HSE and the number of discretionary medical cards in circulation has increased from approximately 52,000 in the middle of 2014 to over 106,000 at the end of May 2016. The programme for Government commits to maintaining that humane approach to discretionary medical cards. The Deputy has provided many details today; perhaps he could forward precise details on the case in question to the Minister for Health. The medical card assessment team is now liaising much more closely with local health officers to ensure that any significant extra information is taken into account. However, the legislation is clear that qualification for a medical card is means tested and some people are not eligible because their income is too high. We want a humane approach and to take into account all the facts relating to medical situations, such as undue hardship that may be caused by the decision not to give someone a medical card. The case referred to by the Deputy has been refused on appeal but, given the details he has outlined, I suggest he forward them to the Minister for Health.

There is now increased funding to the health services for cataract operations and there is a commitment in the programme to the National Treatment Purchase Fund, which can address cases where urgent operations are needed. The Minister for Health can engage directly with the Deputy regarding cataract operations.

I appreciate the Tánaiste's response but the case I gave her today is just an example. Every politician in this House knows of cancer patients and I recently had a child with a prosthesis who was refused a medical card. These decisions are being taken by deciding officers and, while I am not a medical person, I have enough cop on to know that a discretionary medical card is meant for a person in this man's situation, for others like him and for people with cancer. They might not always want a card but at a time when they are ill and their illness is causing them financial hardship, they should be entitled to a card. That is why we call them "discretionary" medical cards. I am simply asking for more discretion to be given. It is completely beyond me how any medical officer can stand over some of the decisions taken in this regard. It is outrageous to allow people to go blind for the sake of €2,700, the cost of a cataract operation. I personally know of people who have gone blind. I can give their names, addresses and PPS numbers and it is outrageous that this should happen in a civilised and modern society.

The Government's intention is to provide the best possible health service. There have been very significant increases for the health services over the years and €500 million was given to the health services just two weeks ago so that we can deal with the situations outlined by the Deputy and prevent the consequences to which he referred. A good health service works at a preventative level to ensure these situations do not arise.

The individual who assesses an application has to consider whether undue hardship exists in determining an entitlement to social and medical cards. Discretion is allowed and we want discretion to be used in appropriate cases. The Minister for Health will want to hear about it if there are ongoing issues regarding the appropriate use of discretion and I am sure he will address it.