Róisín Shortall (Dublin North West, Labour)

I propose to take Questions Nos. 8 and 11 together. A number of difficulties arose with the processing of medical cards in the final quarter of last year. These difficulties gave rise to a very large backlog and long delays for both new applicants and medical card renewals. A separate significant backlog also arose in respect of medical card appeals.

Reviews of the problems have identified a number of factors as to how these problems arose, including the decision by the HSE to fully centralise the processing of medical cards before the centralised service was fully resourced, a significant backlog that already existed prior to centralisation, poor communication with medical card applicants and the public, limited support from local health offices and poor communication between local offices and the centralised service and poor administrative and customer service practices and procedures in the handling, filing and processing of medical card documentation.

These issues are a matter of serious concern to me and I have had a number of meetings with the HSE over the past number of months to raise my concerns. The HSE has introduced a number of changes in recent months to the administration of the medical card application system.

These include increased staffing levels in the centralised processing service and in respect of medical card appeals, improvements to how medical card renewals are assessed and the frequency with which they are assessed, increased flexibility for GPs to add certain categories of patients to their GMS lists, and the fast-tracking of backlogged cases and cases where documentation has been misfiled. A number of additional changes will be implemented by the HSE in the coming months. I am particularly keen to see changes to how medical card renewals in respect of people with permanent disability are assessed. I am in discussions with the HSE on this and other matters and expect changes to be implemented soon.

While a number of customer service and communication issues remain to be addressed, the HSE has nevertheless been making good progress in eliminating the backlog and preventing further backlogs occurring. The HSE has reported to me that 96% of completed applications received in late February and early March have been processed within 15 days, compared to a turnaround target of 90% in its service plan for this year. The HSE has also reported to me that the backlog in processing applications from last year has been reduced by 77% since January. As of yesterday evening, the backlog in respect of medical card applications and renewals had been further reduced to 10,770, down from 58,000 in January, and in the vast majority of these cases, additional information is awaited from the applicant. The backlog in respect of medical card appeals has been reduced to 569, or less than half of what it was in January. The HSE is on course to clear both backlogs by the end of the month.

Average waiting times are not collated because the performance metric used by the HSE is the 15-day turnaround time for complete applications. I have reported the latest information for that measure. For January 2012, more than 47,000 new and renewal applications were received. As of 21 March, 3,700 applications were incomplete and the HSE is assisting people with their applications. Some 42,600 applications have been completed, and 1,000 other applications are in the process of being completed by the PCRS.

Additional information not given on the floor of the House.

Figures for January 2011 are not available to PCRS as the centralisation programme was only completed on 1 July 2011. Prior to that date local health offices were responsible for processing medical card applications. Finally, a review of medical card processing has been undertaken by PricewaterhouseCoopers on behalf of the HSE and contains a number of recommendations that the HSE is considering.

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