Ciarán Lynch (Cork South Central, Labour)

I thank the Ceann Comhairle's office for allowing me to raise the inordinate delays that can occur when medical card applications need to be reviewed.

On 22 February, in reply to a Topical Debate on the processing of medical card applications, the Minister of State told the House she expected the backlog of applications to be dealt with by the end of April. I would be grateful if the Minister would update the House on whether this target has been met. My office, which is in regular contact with the primary care reimbursement scheme, reports a considerable improvement in the ability to make contact with the PCRS staff and an improvement in the through-put of applications.

It appears, however, that there are still anomalies in the system that relate specifically to situations where applicants supply additional or revised information to the PCRS. In those cases, it takes an extremely long time to have the application reviewed. It is not the application that is the problem but if a review process is started, it creates a delay that can go on for an indefinite period.

In one case that prompted me to raise this issue, the most recent phase of one constituent's application for a medical card began in February of this year. Subsequent evidence was requested and supplied. That evidence related to home improvement loans needed to upgrade the heating to the standard necessary given the spouse's medical condition. This person had a circulatory problem and the central heating had to be installed to address this. It took a month to review the submitted information, which was ultimately rejected as evidence of a home loan.

This creates an anomaly. The reason the loan was refused was that the person had the central heating installed by the gas company instead of getting a loan from the credit union. Because the gas company was involved, it was not classified as a home loan and was therefore outside of the assessable means. It is strange that if someone gets the gas company to install central heating, the PCRS staff do not classify that as a home loan but if the person goes to the credit union to pay for the installation, it is classed as a home loan. I hope this anomaly will be corrected.

The second problem arose regarding the household income. The person got home help hours but ceased working as a home help and because of this another review was required. Proof was provided that the household had no income other than social welfare payments and receipt of this information was acknowledged on 25 April 2012.

However, some 15 working days later the promised review had not been completed and, to my knowledge, it has still not been completed as of this afternoon. This highlights a second anomaly. The HSE website suggests a medical card application can be processed from start to finish within 15 days. However, an apparently simple review cannot be completed in that time. Between my contacts and those of the staff in my office, we have made 25 separate contacts with the Primary Care Reimbursement Service during April and May on this single case. Although not as extreme, similar delays have occurred with other applications for review.

I emphasise that this is not an exercise in criticising the HSE or the PCRS. Rather it is an attempt to relieve the distress of a couple who urgently need the benefits of a full medical card. It is also an attempt to highlight the anomaly in the system. Is the planned provision of general practitioner visit cards for patients with a long-term illness on schedule? Ultimately, there is an anomaly and I would be grateful to hear how the Department will respond to it.

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