Oireachtas Joint and Select Committees

Thursday, 12 December 2013

Committee on Health and Children: Select Sub-Committee on Health

Estimates for Public Services 2013
Vote 39 - Health Service Executive (Supplementary)

10:50 am

Photo of James ReillyJames Reilly (Dublin North, Fine Gael) | Oireachtas source

I will deal with Deputy Kelleher's latter point and let Mr. Byrne deal with the more technical aspects that were raised by Deputy Ó Caoláin. The bottom line here is very clear. There has not been any targeting of discretionary medical cards; a probity exercise has been ongoing.

We mentioned the Committee of Public Accounts and its members would be the very first to haul us before them and ask why we are giving medical cards to people who should not have them or why we are paying doctors or pharmacists when we should not be. That process has been ongoing throughout the year. Members will recall that earlier last year we had a terrible problem with people not being able to get medical cards, with a backlog of 53,000 people. That was cleared and the focus moved to ensuring that people registered with doctors were still in the country or alive, etc.

I will debunk one argument. There is an agreement between the Irish Medical Organisation and the Primary Care Reimbursement Service, PCRS, that allows a GP the facility to put a newborn baby on the list without having to wait months for the HSE to do it. The quid pro quois that the doctor must remove anybody who has passed away. We have already considered the "high risk" cards; in other words, these are cards that have seen no activity for a year and where no prescriptions have been written. We would examine them to see if the people are still here or if they have moved, etc.

The bottom line is the highest number of people in the history of the State have medical or a GP care card. There are 1.865 million people in the medical card scheme and another couple of hundred thousand people with a GP care cards. To say there has been a drive to target any particular group, especially with regard to discretionary medical cards, is wrong. Part of the debate about discretionary medical cards indicates that a significant number of affected people have been converted to full medical cards. Nevertheless, people had cards to which they were no longer entitled. That came from the disparity in the system. The Chairman has argued that we should call it what it was, which was a system of nod and wink. Depending on who a person knew, they may have got a card. As a result, certain parts of the country have a low level of discretionary medical cards but in others the level was very high. That did not bear examination. I know everybody in the room would like to see a position where everybody could have a medical card but we want to ensure that everybody has free GP care.

There has never been a time when a particular condition or illness entitled a person to a medical card. Discretion was shown where a particular medical condition created financial hardship.

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