Jan O'Sullivan (Limerick City, Labour)

I thank the Deputy for raising this issue. The Minister of State, Deputy Shortall, is on official business in Northern Ireland and telephoned me to ask if I could take this debate for her. I apologise on her behalf but she could not be present.

This debate provides me with an opportunity to set out the steps being taken to address problems that have arisen in the processing of medical cards. The final part of the centralisation project took place on 1 July with the centralisation of medical card processing and associated tasks for the entire country in the PCRS's office in Finglas, Dublin. For the first time in the State's history, a single uniform system of application processing has been put in place. It replaces the different systems previously operated through more than 100 offices across the country. Some of the changes that have been introduced include the www.medicalcard.ie website and the standardisation of medical card assessments.

The new arrangements should ultimately provide for a far more accountable and better managed medical card processing system. However, there have been difficulties. These issues are a matter of concern and the Minister of State has held several meetings with the HSE to raise them. She has been hands-on in addressing the matter. As a result of those discussions, a number of changes are being introduced to the medical card application system to assist in accelerating the turnaround for applications by easing the level of pressure on the medical card system, particularly with respect to the review process, which has placed a large demand on the resources of the centralised office due to the timing of the re-issuing and, hence, review of a large cohort of medical cards.

In 2010, the central office introduced a self-assessment review process for people aged 70 years and over, as that cohort was managed entirely by the central office. Following on from this development, from January on the HSE will ease the review process for all pensioners. This change will mean that reviews for medical cardholders who are 66 years of age or older will operate on a self-assessment basis, as currently happens with those aged over 70 years. The self-assessment review model will also be extended to medical cardholders under 66 years of age who were granted their medical cards on the basis of a means assessment and who the HSE is satisfied is living in this jurisdiction. The HSE is also standardising eligibility periods from two years to three years for people aged under 66 years, with a new four-year eligibility period for medical cardholders aged 66 years or over.

Notwithstanding this, there continues to be an obligation on all cardholders to notify the HSE of any change in their circumstances that would no longer entitle them to hold a medical card. The HSE is in the process of arranging access to data in the possession of the Revenue Commissioners and the Department of Social Protection to allow them to conduct reviews without troubling medical cardholders for further documentation. It is also intended to increase the fine applying to false claims in a forthcoming Bill.

Discretionary cards, emergency cards and cards held by people in a small number of other categories will continue to be reviewed in the normal way but the HSE is confident that the extension of the self-assessment model to the great majority of medical cardholders will simplify the process substantially, improve the service to the client and continue to improve turnaround times for reviews. It is hoped that ultimately 80% of renewals will be dealt with in this way.

The new process also focuses attention on active users of the medical card in order to ensure those most in need are captured within the streamlined process. In addition, from 1 February, the HSE will implement a new system which gives GPs the additional ability to identify and assist the most vulnerable medical card holders. GPs will be able to maintain the eligibility of these patients where they are going through the renewal system. They will also be able to add newborns to the medical card system online.

The Minister of State, Deputy Róisín Shortall, wishes to emphasise that in no circumstances should a medical card holder who genuinely engages with a review have his or her entitlement withdrawn before that review is complete. This is unacceptable. Some such cases were brought to her attention in recent weeks. The HSE is taking steps to ensure the rule is properly implemented.

In addition, the primary care reimbursement services's central office is working to deal with some of the processing issues that have arisen. This has included reviewing and refining the systems for the receipt and logging of applications and documents sent in following requests for additional information. In addition, the PCRS has received further staff resources this month as a result of a transfer from the Central Statistics Office. This should make an impact on processing times. My colleague, the Minister of State, Deputy Róisín Shortall, will continue to monitor the situation and has arranged to meet the HSE on a regular basis to discuss any issues that may arise with respect to medical cards.

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