Reilly brings proposals to Cabinet for reinstatement of medical cards

Minister for Health to move on restoring 1,200 discretionary cards taken away this year

Dr James Reilly: to present Ministers with a number of options for restoring the cards which have been withdrawn in recent months. Photograph: Alan Betson
Dr James Reilly: to present Ministers with a number of options for restoring the cards which have been withdrawn in recent months. Photograph: Alan Betson

Minister for Health James Reilly is to table proposals at Cabinet tomorrow for the reinstatement of thousands of discretionary medical cards withdrawn during the recent controversial review process.

Dr Reilly is expected to present Ministers with a number of options for restoring the cards which have been withdrawn in recent months, including an administrative scheme that would cover those most recently deprived of discretionary cards.

Last week, the Dáil Public Accounts Committee heard almost 1,200 discretionary medical cards had been removed since the start of this year. The Government has been heavily criticised for the removal of cards from seriously ill patients, and the issue is seen by backbenchers as one of the main reasons for the poor performance of Fine Gael and Labour in the last month's local and European elections.

Department of Health officials, who have consulted with Attorney General Máire Whelan, are still working on the detail of the proposals to go before Cabinet tomorrow.

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Medical conditions

This process is separate from the HSE expert group which is currently looking at which medical conditions would qualify for an illness-based system of awarding medical cards, as proposed by Government.

Meanwhile, the vast majority of people refused a discretionary medical card since the start of last year earned at least €250 a week over the guideline for eligibility, according to new HSE figures.

One quarter of the 5,860 unsuccessful applicants were at least €500 over the weekly income guideline, while half were €250-€500 over the limit. The rest were earning up to €250 a week more than the guideline.

A total of 17,388 people who had eligibility for a discretionary medical card at the start of last year had lost it by April this year. Aside from the 5,860 refused because they didn’t satisfy eligibility criteria, 1,327 had died and 7,886 were deemed not to have responded to correspondence. Smaller numbers were asked to provide additional information or had lost their card in circumstances where other family members were provided with eligibility.

According to a HSE briefing document, the total number of medical cards was reduced by 10,000 in 2013 and by 50,000 in the first four months of this year. Since late last year, data sharing with the Revenue Commissioners has allowed the HSE to target for review “high-income individuals who may not be eligible for a card. Cost savings are expected from these targeted reviews”.

‘Perception of harassment’

Data sharing with the

Department of Social Protection

would also generate savings.

According to John Hennessy, HSE national director for primary care: "The HSE is receiving some concern from cardholders who are subjected to more than one review in a short timeframe. Genuine random reviews will exacerbate the perception of 'harassment' and this control may need to be reviewed in light of these concerns."

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.