Andy,
I had to try because this was doing my head in now!
Just a quick checklist (your on debian now right)
Have you run/installed with no errors?
apt-get install opensc pcscd libccid
You have the file opensc.conf in etc/opensc/ folder
The easiest way i found to edit file was open it through winscp and edit the file, you see the whole file then!
Look for or right click and find the three lines (there are all over the file)
Find (login) Find (emulation) find (pcsc)
When you see the lines that look indentical delete the # symbol to make the line readable/live
Remove openct from line reader_drivers = openct, pcsc, ctapi; (ensure this is also unhashed #)
Save the file
Ensure that the correct port is defined in oscam.server
Reboot and it should find it and work?
Is you card reader working? Plug into windows pc and see if it installs drivers and Green light shows up on reader?