Kathleen Lynch (Cork North Central, Labour)

I am responding to this matter on behalf of my colleague, the Minister for Health, Deputy James Reilly. I thank the Deputy for raising it as it provides me with an opportunity to set out the progress made by the Health Service Executive's initiative to standardise the processing of medical cards throughout the country. Medical cards are provided to persons who, in the opinion of the HSE, are unable, without undue hardship, to arrange general practitioner medical and surgical services for themselves and their dependants. While income guidelines are the principal benchmark used for deciding medical card eligibility, the HSE also has regard to other matters considered appropriate in assessing a person for a medical card.

The HSE implemented its decision to centralise the processing of all new applications and renewals of medical cards at the primary care reimbursement service, PCRS, in Finglas, Dublin, on 1 July 2011. Following the centralisation of the service, the PCRS reported that it was receiving approximately 20,000 applications per week. The PCRS estimates that in excess of 80% of complete applications are processed within 15 working days. Delays can occur where applications are submitted without the correct supporting documentation necessary to complete the processing of the application.

All applications are given a unique application number by the PCRS, which is immediately notified to applicants. Applicants are advised of the importance of quoting this unique application number on all correspondence with the PCRS because it is used to track all correspondence as well as the current status of the application. In cases where an application is not complete, the PCRS writes to the applicant requesting the missing documentation.

In cases where a decision is made not to grant a medical card, the applicant is informed of the decision, notified of his or her right to appeal this decision and contact details for the appeals office are provided. Where appellants submit an appeal within 21 days of a decision, they retain their medical card or GP visit card until the appeal is decided. The appeals officer notifies the appellant of the final decision in the case.

In 2010, as part of the centralisation project, the HSE introduced a new website, www.medicalcard.ie, which enables people anywhere in the country to apply for or renew a medical card through a simple and efficient application process. Thousands of applications are now submitted online every month. Applying online also gives applicants access to up-to-date information on the progress of their medical card renewal or application.

Following centralisation, staff in local health offices continue to provide information and assistance to individuals in regard to their applications for medical cards. They also provide information on the current status of a person's application or review by tracking the application on the PCRS system. The centralisation project is part of the HSE's effort to deliver efficiencies and reduce overhead costs in a manner that minimises the impact on front line services. The administration costs of the PCRS represent less than 1% of the value of the payments processed by it.

The progress of the centralisation project is being continuously monitored and, if required, modifications will be made to address any issues arising. Centralisation delivers consistent and equitable application of eligibility and service provision. It also facilitates clearer governance and accountability, as well as improved management information. Nevertheless, I very much take on board the Deputy's point that for people who are not computer literate, particularly elderly people, it can be a daunting process.

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