Thomas Pringle (Donegal South West, Independent)
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To ask the Minister for Health the reason many elderly persons have had their medical cards cancelled by the primary care reimbursement scheme without any notice; the steps being taken to ensure that the system prevents this happening again avoiding undue distress and cost on elderly patients; and if he will make a statement on the matter. [14090/13]

Alex White (Dublin South, Labour)
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Under the provisions of the Health Act 1970, as amended, determination of eligibility for a medical card is the responsibility of the HSE. The HSE has produced national assessment guidelines to provide a clear framework to assist the making of reasonable, consistent and equitable decisions when assessing an applicant. These guidelines are publicly available and can be downloaded from the HSE’s medical card website.

A new medical card scheme for persons aged 70 years or over was introduced with effect from 1 January 2009. Under this scheme, a person who is ordinarily resident in the State qualifies for a medical card as long as their gross income does not exceed the means test income limit. The income limit for a single person is currently €700 per week. The relevant income limit for a couple is €1,400 per week.

The standard procedure for the review of medical cards for persons aged 66 years or older is that their medical card will be reviewed every four years. In the interest of fairness between medical cardholders, it is important that all people aged 70 years or over are treated in a like manner by the HSE. The primary care reimbursement office, PCRS, has confirmed that medical cards are not cancelled without notice. The PCRS notifies all medical card holders by letter three months in advance of the renewal date of their eligibility for a medical card, or when a review is due. A further reminder letter is sent to card holders who have failed to return their renewal form a month prior to the card expiry date. If no contact is made by a client with the central office within this period, their medical card will expire. The central office makes every effort to contact clients. In a small number of cases a client may not receive the renewal notice due to having changed address. When notified of such cases the central office extends the person's eligibility for a sufficient period to allow them to complete and submit a renewal.

Additional information not given on the floor of the House

Any medical cardholder undergoing a review for a renewed medical card, who genuinely engages with the HSE in that review, will not have their entitlement withdrawn before the review is complete, regardless of the expiry date shown on their medical card. In cases where a decision is made not to grant a medical card, the applicant will be informed of the decision and notified of their right to appeal this decision. Contact details for the appeals office are provided to them with that decision. Where a person submits an appeal to a decision not to renew a medical card within 21 days of that decision, they will retain their medical card until the appeal is decided. In conclusion, all efforts are being made to deal with the individuals properly, fairly and impartially.

Thomas Pringle (Donegal South West, Independent)
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I put down this question because I have been contacted over recent months by a large number of elderly people who had their cards cancelled by the PCRS without prior notice. Indeed, when contacted, the PCRS acknowledged that the system did not send out the letters to the people concerned, and it reinstated the cards. However, this has caused huge distress for elderly people who, when seeking to renew their prescription, were told by either their GP or pharmacist they did not have a valid card. There was some type of system failure within the PCRS. It must be identified and steps must be taken to ensure the system does not allow such incidents to happen again. Elderly people should not have to go through that type of distress. They should always be notified.

Alex White (Dublin South, Labour)
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I can only agree with the Deputy that this should not occur.

I ask him to relay to me details of cases where people were not notified in the manner that I have been advised is practice. I am satisfied there have been significant improvements recently in the administration of the medical cards system and primary care reimbursement system, PCRS. While it may well be the case that the system does not work at full throttle in all circumstances, I am convinced it is working very well. If the Deputy provides me with details of the specific cases he raised, I will address them.

Where someone is undergoing a review or is uncertain about the nature of the contact, it is vital that he or she engage with the service. In most, if not all, circumstances a proper resolution will be found.

Thomas Pringle (Donegal South West, Independent)
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I thank the Minister of State for his response. I will arrange to have details of the relevant cases sent to him. When my office contacted the primary care reimbursement system, the medical cards of the individuals in question were reinstated as soon as it was realised that a system failure had occurred. The problem, however, is the distress caused by such failures. The system should be sufficiently robust to prevent such cases or at least minimise the number of them.