Joe Costello (Dublin Central, Labour)

I presume I am not the only Deputy who thinks people in his constituency are experiencing considerable delays in the processing of medical card applications and renewal applications. I have not seen anything like it in my life as a public representative. The delays are horrendous. Sick, old and disabled people are suffering because the Minister for Health and Children and the HSE decided to impose a system of processing medical card applications on top of a system designed to process the primary care reimbursement service, PCRS. The Minister should have learned from what she did with the HSE, imposing that layer of bureaucracy onto the health board system which, in itself, has been a disaster. She has now combined with the HSE to place this tier of centralisation of medical card applications and renewals on top of another system designed for an entirely different purpose.

There have been long delays, files have gone missing and there is chaos in the system. In the last analysis, the most vulnerable people suffer because they are the ones looking for medical cards and renewals; they are those left waiting and under stress, strain and anxiety because of the mismanagement and insensitivity in the way the HSE and the Minister for Health and Children have dealt with this matter.

There is a great lack of information for applicants. The actual service being provided in the PCRS is amazingly secretive. It is almost like Fort Knox. A person cannot simply turn up. The place is guarded by dogs and security personnel and ordinary members of the public cannot go near it. I understand the centre is in the Minister of State's constituency but people must deal with it as if it was a limbo situation. It is non-personal and there is no opportunity for a person to speak with personnel to ask how his or her application is processing. It has gone into the secretive centralised centre to which nobody has access - not a good approach in terms of transparency and dealing with the public. I understand the PCRS was not consulted about this plan but that it was simply announced and then imposed on that body which did not have the services, personnel or resources to cater for this. Belatedly, the Minister has begun to provide some resources.

As early as 19 January, the Minister told the Oireachtas she fully supported the centralisation of the medical card application process and that centralisation would make the whole system more efficient. She said at the time it would take only 15 working days to process an application. That is cloud cuckoo land. The situation has not improved. I will be interested to hear whatever figures the Minister of State will trot out but six months later there is no sign of any improvements or improved efficiency in the system. It still takes months to process applications and renewals and many of the files go missing in transit.

I must agree with the statement of the Ombudsman, Ms Emily O'Reilly, who said the HSE is living in another world. The Minister is also living in another world; it certainly is not one related to reality. The Ombudsman was speaking about her own dealings with the HSE which she described as being from Alice in Wonderful. We all experience this.

I do not know whether the Minister of State has a hot line to deal with medical card applications for his constituents but the system is not working satisfactorily. It may be that only my constituency is experiencing this dire service. However from comments I have heard from colleagues it seems this is a universal problem throughout the country. I noted many cases that I have forwarded to the HSE and to the Minister. The Minister acknowledges them and says she must send them to the HSE. The HSE come back to me after a long time with replies. It is very unsatisfactory and everything is in process. It is in a state of chassis and it does not reach a conclusion.

I would like to know whether there will be any improvements in the existing system and why there are so many people in my constituency who find this dire situation in regard to their applications for new medical cards or renewals.

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