Séamus Healy (Tipperary, Workers and Unemployed Action Group)
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This Topical Issues matter concerns the need to address the delays in processing medical card applications. It is no reflection on the staff working in the medical card section. I compliment the staff, in particular, those dealing with the receipt, registration and processing of medical card applications. My office is in touch with them daily and find them to be very courteous and helpful. My office and I also appreciate the work being done by staff dealing with urgent and emergency medical card applications. My office also deals with them on a regular basis and find them to be professional, helpful and courteous.

I am making a plea for additional staff for the processing of medical card applications as there is a serious delay in the registration and logging of new applications and further information. I will give some examples, of which there are many. I refer to the standard application received from a single person, whose only income is jobseeker's allowance and who forwarded an application on 31 October. Notification of receipt was received by email on 31 October. On 14 November the application had not even been logged on the system.

Another example involves a request for further information. The information was sent on 10 October. Again, receipt was acknowledged very quickly on 11 October, but on Friday, 9 November its registration and logging had still not been completed.

I have another example of a request for further information. It dates from 12 November. Receipt of the additional information was also acknowledged quickly on 15 November, but as of today, 21 November, it has not been logged on the system for the processing team which was only dealing with information dating from 9 November.

In the logging and registration of applications there is a serious delay of two to three weeks and more in some cases. The delays are significant and causing distress and concern for applicants. I will give an example of what can happen. There was a case recently where further information was sent by an applicant. Its receipt was acknowledged by email, but a few days later the applicant receiving a letter requesting that the further information be sent or the medical card would be withdrawn. The applicant came back into my office. It was again confirmed that the information had been received, but it had not been logged on the system. It led to the medical card being withdrawn.

There is a serious issue in the registration of applications and additional information. It is taking two to three weeks and sometimes longer for registration to happen. It is causing major delays and the only reason is the lack of staff to deal with the work involved. Will the Minister of State talk to the Health Service Executive to ensure additional staff will be put in place to make sure applications are dealt with efficiently and speedily? The lack of a medical card can give rise to major difficulties and great distress for applicants.

Jim Daly (Cork South West, Fine Gael)
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I thank the Deputy for raising this issue. The Government is conscious of the importance of the medical card system in ensuring people whose needs do not enable them to access general practitioners, GPs, and other health services will be provided with such supports in line with legislative provisions. As the Deputy will be aware, the medical card system is based primarily on the assessment of an individual's financial means. Therefore, the vast majority of applicants for a medical card are required to undergo the assessment process. The Deputy has raised concerns about the delays in dealing with medical card applications. I have been assured by the HSE’s national medical card unit that there are no delays in the processing of medical card applications for any category of applicant, either new or those subject to a review.

It should be noted that in the period from January 2018 to date the HSE's national medical card unit has consistently met its key performance target to have 95% of complete medical card applications assessed for eligibility within 15 days. It is currently processing all fully completed applications within 15 working days across all application form types. There will, however, be situations where the application process may take longer than the 15-day target time. In some cases, as part of the assessment process, applicants will be required to provide additional documentation to enable the national medical card unit to access whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family. Every effort is made to ensure ongoing engagement between the HSE and applicants during this process.

Additional time may also be required to process applications in situations where an applicant's income exceeds the medical card threshold and he or she is then assessed by the national medical card unit for a discretionary medical card. In this situation, in order to take full account of the difficult circumstances which may apply, additional information such as evidence of the extra costs arising from an illness, will be requested from the applicant. The national medical card unit affords these applicants every opportunity to furnish supporting information and documentation to take account of all relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.

In summary, the HSE has indicated that there are currently no delays in processing fully completed applications for a medical card. However, where an applicant is requested to provide further or additional information, the process may take longer. The delay is necessary to allow the HSE's national medical card unit to make a comprehensive assessment of the application.

I also point out that where notice of a review of a medical card has been initiated, it is provided three months in advance of the date of expiry. This is to afford individuals an extensive time period to provide any required documentation. It is also important to note that during the review process persons will continue to hold eligibility. In addition, the HSE strives to have an application process for medical cards which is as streamlined and straightforward as possible for all applicants. Assistance is offered to persons completing application forms through the national medical card unit and local health offices. The HSE has also put in place a number of new measures oriented towards improving the efficiency and effectiveness of the medical card application process. On 15 January it launched its new medical card online service at www.medicalcard.ie. The new system enables people to make online applications for a medical card and is faster and more convenient than the current paper based system.

Séamus Healy (Tipperary, Workers and Unemployed Action Group)
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I know the Minister of State is reading information he got from HSE officials but they are simply burying their heads in the sand. There is a general problem with the registration and logging of applications, particularly with respect to further information. I see this on a daily basis and I know other Members are similarly aware of it. The HSE is assuring the Minister that there is no delay in the processing of these applications but I am not sure what that means. I ask the Minister of State to check this with the HSE as there is a general problem with logging on and registering further information with medical card applications. As of today, my office has been told the officials are dealing with information received on 9 November, which is a fortnight ago. That two-week delay is the current position. I ask the Minister of State to check this with the HSE.

Additional staff may be necessary to deal with applications and there is a need to upgrade information technology systems. There is a main IT system and an Oireachtas system and it appears these systems are not compatible and are not talking to one another. We also need to have a process similar to that provided by the Department of Employment Affairs and Social Protection, whereby Members can deal directly with dedicated staff dealing with these applications. There is definitely a difficulty with the area and I again ask the Minister of State to check this with the HSE as it is giving rise to serious difficulties for ordinary people trying to access medical cards. I compliment the staff at all levels in the medical card area as we find them courteous, helpful and professional. However, as there is still a problem in the system, I ask the Minister of State to look at it.

Jim Daly (Cork South West, Fine Gael)
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I thank the Deputy and I welcome and acknowledge his comments about staff in the medical card section. As well as being a Minister of State, I am a constituency Deputy like Deputy Healy, and I often have occasion to deal with the staff in the medical card section who I find unfailingly courteous, obliging, helpful and responsive. I also note what the Deputy told me. According to the HSE, 95% of all completed applications are processed within 15 days. The Deputy is talking about incomplete applications. As a constituency Deputy, I appreciate that he is saying the application forms are difficult and often incomplete when submitted. Information is sometimes missing and has to be requested, as the Deputy highlighted.

I will check with the HSE the issue the Deputy brought to my attention. I absolutely respect his bona fides and I know he has no desire to make anything up or highlight the matter for the sake of it. The Deputy is a politician with a democratic mandate and if he or people in his office say they are experiencing delays, I have no doubt they are being experienced. I will check the matter with the HSE. The Deputy's comments were the first I heard about a two-week delay or staff advising that they are only dealing with information submitted on 9 November. That is news to me. As the Deputy will appreciate, when scripts are being prepared, we do not know what details Deputies will raise. He is around the House long enough to understand that. I will examine the issue with the HSE and convey the Deputy's concerns to the medical card processing unit. I thank him again for raising the matter as it is what we are all here for.