Of course it goes without saying that people should not be paying to attend hospital appointments that involve travelling across half the country because the services aren't available locally. However, as such journeys are necessary to suit efficiencies within the HSE, perhaps the HSE should be paying rather than Irish Rail. I suspect that the vast majority of free travel scheme users are actually using their passes in this way.
Similarly if somebody has a condition that makes it difficult to drive and they have been granted a pass to help their mobility, they should have blanket use of the trains. Where some effort should be made to move journeys off-peak is where people are going up to Dublin to do a bit of shopping or for other recreational reasons.
These journeys are of course socially useful and can be essential to an elderly person's mental well being. But these purposes can be met equally well by the person travelling off-peak and everyone is a winner. It might even end up creating a virtuous circle whereby Irish Rail would gain the financial resources to run later services and so enable people travelling on free-travel passes to stay in Dublin for an evening meal thus driving further use of public transport.
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