Minister for Health James Reilly has defended the HSE's processing of "discretionary" medical cards, insisting that policy has not changed in the last year.

Dr Reilly said the system continued to operate in such a way that those who suffer financial hardship as a result of a medical condition, receive the benefit of a medical card.

Speaking separately at an event in Limerick, Taoiseach Enda Kenny said up to 97 per cent of those over 70 would keep their medical cards.

But addressing the Oireachtas Committee on health this morning Dr Reilly said a review of discretionary medical cards had shown almost half of reciptients were 200 per cent above income guidelines.

Dr Reilly said following reports in the media of “vulnerable” people being denied discretionary medical cards, he had this week met senior HSE officials to examine the operation of the scheme.

He told the TDs and Senators that in March 2011 there had been 97,121 holders of discretionary medical cards and as of 1st of October this year, 39 per cent of those still held their discretionary medical card. He said 43 per cent had migrated onto an ordinary medical card based on an assessment of means.

The number of people who had been deemed ineligible for either a “GP visit card” or a full medical card was 6,324, or 6.5 per cent of those who had a discretionary medical card in March 2011, he said.

Dr Reilly said the assessment criteria had found that after allowances were made for loans, mortgages, rent, travelling to work and all medical expenses, 49 per cent of these cases were “still over 200 per cent above the guideline (income) amounts for eligibility.”

He said some “92 per cent of the ineligible cases “were still 50 per cent above the guideline limits” for eligibility “taking into account all the allowances available to them”.

Dr Reilly said that since he had become Minister for Health there had been 36,000 cases of approvals for discretionary medical cards and since January of this year had been “23,000 new medical cards issued on a discretionary basis”.

He said he had directed in mid-2011 that the system of approval for such cards be centralised, to eliminate regional inequities and ensure that “all people were assessed in a fair way”.

“So I want to ensure people that there has been no change in policy, but what there has been is probity”.

He also pointed out:

* an additional 250,000 medical cards are in circulation since 2011

* 43 per cent of the population now have access to free GP care

* The figures represent the highest number since since records began.

* Some 49 per cent of the population are expected to be covered for free GP care, following measures in this week’s budget.

Dr Reilly said the increasing numbers of those who were availaing of free GP were in line with policy “so that less people end up in hospitals which is the most expensive end of the service”.

But he warned “there is not and there never has there been an automatic right to a medical card on the basis of a specific illness or a specific condition. That is the reality of the 1970s act.

“If we wish to change that then regulations will have to be brought before both houses of the Oireachtas to so do,” he said.

Taoiseach Enda Kenny said up to 97 per cent of older people would keep their medical cards.

Speaking in Limerick, he also insisted that older people would not be left without vital home security links following the abolition of their monthly telephone allowance.

When asked about fears of a “grey revolt” in the wake of budgetary changes to eligibility for medical cards for those over 70, Mr Kenny warned against any “scaremongering”.

“There isn’t any room for scaremongering, that everybody is going to lose medical cards. There is a system here that is income based. Since this was centralised a number of years ago the assessment process is the same for everybody so those people who are clearly under the income guidelines for medical cards need have no worries their cards will continue,” he said,

“The change made in eligibility affects a very small number of higher earning people over 70 and when that change is completed the proportion of people over 70 who either have medical cards or GP cards will still be in the high 90s - around 97 per cent,” he added.

Mr Kenny insisted he values greatly the contribution that older people continue to make to society.

However he confirmed that there would be no roll back on the axing of telephone allowances for pensioners as announced in this week’s budget.

The Taoiseach also confirmed today that there would be no cabinet reshuffle this year.

“I have already indicated it will be in the second half of the government that will not happen this year. It is a matter I will reflect on, as is my responsibility.”