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Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: I also welcome the representative from the Department of Public Expenditure and Reform. He might introduce himself.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: I welcome all of the witnesses to this important session of the committee. I now call on the Comptroller and Auditor General to introduce the accounts.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: I now ask Dr. McLoughlin to make his opening statement.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: I thank Dr. Ambrose. May the committee publish his statement?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: I now invite Mr. Tony O'Brien, CEO of the HSE, to make his opening statement.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: Thank you. May we publish the statement?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: I wish to deal with a number of issues specific to medical cards. As Deputies on the ground, we know a major issue for constituents is the discretionary medical card. Having read the material provided, it can be said about people with discretionary medical cards without fear of contradiction that they are seriously ill, as they would not have qualified for the discretionary medical card...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: It is very simple for us. For the general public looking at this, and particularly those on discretionary medical cards, it is apparent that these were given on the basis of a serious medical condition. I am basing my assumptions on the HSE figures. At the start of January there were 63,136 and at the end of September there 52,733, which is a change of 10,393. Is that correct?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: This was provided to the committee by the Department of Health. The numbers are on the screen.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: No-----

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: I have limited time and I understand from where the witnesses are coming.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: I am making a different point, which is very simple. Of the 10,393 people, 6,282 got GP visit cards, with an increase in GP visit cards as there is a direct correlation between a reduction in medical cards and their change to GP visit cards. Of the 45,000 withdrawn medical cards, a quarter came from discretionary medical cards, but those cards only make up 0.3% of the total number of...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: Therefore, 50% were more than 200% above the guideline figures.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: Mr. Burke is saying there are approximately 6,700 discretionary medical cards for which people did not qualify on means grounds.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: Mr. Burke is missing the point. Will he give me the precise figure? Is it 6,324?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: My point is that those 6,324 people have a serious medical condition. In the cases that have come across my desk many of them are disabled children or children with Down's syndrome. They would have had medical cards since birth or from the first year of their lives. I am talking about the system; this is not personal. It is an important issue. Let us say a person has Down's syndrome and...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: Invariably, in the cases coming to our clinics in our constituencies the medical conditions have deteriorated. If one has a child with cystic fibrosis, for example, in many cases his or her asthma has got worse and the condition has progressed. I also see it happening with disabled children. I am talking about that cohort whose medical conditions have not improved.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: When the discretionary medical cards were granted, it was invariably for serious medical conditions from the start. If people were granted a discretionary medical card, up to ten years ago in some cases, and the medical condition of their child, whether the child is disabled or has Down's syndrome, has progressively worsened, how can Mr. O'Brien explain to them that the criteria for...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: On that point, how many of the discretionary medical cards - Mr. Buckley has said 97,121 discretionary medical cards have been issued - have been subject to review? How many of the other approximately 1.9 million medical cards have been subject to review?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General
Chapter 22 - Eligibility for Medical Cards
(14 Nov 2013)

Kieran O'Donnell: I am asking this on an analytical point. How many of the discretionary medical cards were reviewed?

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