John Curran (Dublin Mid West, Fianna Fail)

I am taking this Adjournment matter on behalf of my colleague the Minister for Health and Children, Deputy Mary Harney.

The assessment of eligibility for medical cards and general practitioner, GP, visit cards is statutorily a matter for the Health Service Executive, HSE, and is determined following an examination of the means of an applicant and his or her dependants. Up to the start of this year, medical card and GP visit card applications were processed in the 32 local health areas. However, under the HSE's 2009 service plan, the processing of all medical card and GP visit card applications will be centralised and will transfer to the executive's primary care reimbursement service, PCRS, in Dublin. The change is being implemented on a phased basis and has commenced with the PCRS processing all medical card applications for persons aged 70 years or over. This phased implementation will allow the HSE to monitor the situation and, if required, modify it to address any issues arising.

The decision by the HSE to centralise the processing of applications has been made in the context of the requirement to realise savings in this very challenging economic environment. The change will provide an enhanced standardised service to the client population. It will deliver services for the public within sustainable levels of expenditure and has the aim of achieving efficiencies by the greater usage of shared services. Centralised processing of medical card applications will result in a more consistent and transparent approach being applied and will not have an adverse impact on patient care or the quality of service provided. There will also be no adverse affect on the assessment of people whose income exceeds the income guidelines but who have a case to be considered on medical or hardship grounds.

Under the new arrangements, the HSE will be aiming for a turnaround time of 15 days or less for all medical card applications. Emergency applications will be dealt with immediately with a card issuing within 24 hours. The HSE has advised the Department of Health and Children that there are no plans to close any of the local health offices. These offices will continue to deal with queries of a general nature relating to the medical card scheme and will provide any assistance needed with the application process and, along with the executive's national helpline, will deal with inquiries from clients in respect of their medical card entitlements and completion of application forms. However, the process will involve a reassignment of existing human resources within the HSE.

This is a good example of the type of innovation signalled in the transforming public services programme announced by the Taoiseach last November. It demonstrates how improved services can be delivered within the more limited resources available in a way which meets the needs of citizens in a modern society. I fully support the HSE's decision to centralise the medical card and GP visit card application and review process to one location. The HSE has advised that when fully implemented the measure will ensure an improved turnaround time for the processing of applications, equitable application of eligibility throughout the country, consistency of service provision to customers, clearer lines of governance and accountability and improved unified data.

The number of persons with a medical card has increased by more 290,000 since the start of 2005. More than 1.43 million people are now covered by the card. In addition, more than 93,000 people have a GP visit card.