Alex White (Dublin South, Labour) | Oireachtas source

I certainly will take on board much of what has been said, both by Senator Barrett and his colleagues. For reasons I will indicate in a moment, I am not in a position to accept the amendment proposed but I very much acknowledge the context and argument proposed by him and supported by his colleagues. The amendment is in the general spirit of section 8, which refers to data exchange. These days people say data is king and very often that is the case. If data is available it is sometimes only available in one spot and it needs to be seen by another section or Department. What we provide for in section 8 is data exchange on a statutory basis, which is entirely in compliance with data protection principles and embeds the Data Protection Commissioner in the process by requiring the commissioner to approve any agreements for the sharing of data. The basic principle of data exchange and sharing is established but the protections Senators want to see in terms of privacy and other protections that are in place because of the data protection legislation which dates back to 1988 are also satisfied.

The point about centralising the process is also well made by Senator Barrett and others, where, for example, different activities are going on in different places that there is a strong argument that they should go on in one place or at least to reduce the number of places a particular activity is conducted. I am not an expert on the matter but, curiously, for all the work done by the Revenue Commissioners ? as we know they will do more ? I do not think it conducts means testing. I have not had an opportunity to definitively establish the fact but it strikes me that they are not involved in means testing so this would be a new activity for them. That is something to bear in mind when we examine the appropriate place for means testing to be centralised, were we to consider doing that.

From the point of view of the health Acts, the HSE is charged with legal responsibility to make decisions regarding the eligibility or otherwise of a person ordinarily resident in the State. This legal obligation would remain on the HSE even if the amendment were to be accepted. The HSE would still have to assess the eligibility under the health Acts. The Revenue Commissioners are not equipped at present ? I accept that people are talking about what might happen in the future ? to carry out an assessment of medical cards and GP visit cards as well as other services provided by the HSE.

There has not been universal support for the centralising of applications for medical cards. I consider it has been a great success. Nothing is perfect but there has been considerable success in dealing with the backlog, not without objection and sometimes from our own colleagues on all sides. People were worried about certain changes. The centralising of the processing of all new medical card applications and renewals at the primary care reimbursement service, PCRS, was done with effect from 1 July 2011. Significant progress was made on the national project to provide enhanced service delivery to clients and providing a consistent and equitable national assessment process on which everyone can depend.

The HSE processes in the region of 750,000 applications each year. It aims to have all medical card applications and renewals processed within 15 working days. The latest information, as at 18 March, shows that more than 95% of applications are processed within the target time. Different types of application are made. There is the basic application for a medical card, a GP visit card and it is also required to process applications for discretionary cards which often require a significant medical input. It is important to bear that in mind in the context of the assessment of eligibility. That requires a clinical panel to be put in place. One has recently been established for the processing of the discretionary applications. The medical or clinical dimension is another issue one would have to consider in the context of giving the task to another agency at some point in the future. There is also the emergency process provided by the HSE for a person who is terminally ill or in urgent need of medical attention who cannot afford to pay for it. In such cases a card is provided within 24 hours.

The suggestion that we centralise means testing in a particular agency is not without complication. I am not sure whether the Revenue is the place to do it. I very much accept the spirit in which the proposal has been made. Senator Barrett will be interested to hear about administrative costs and efficiency, as it is very much in line with the arguments he makes in debates, as highlighted by Senator Ó Clochartaigh. The administration costs of the primary care reimbursement service is approximately 0.5% of the cost of the medical card scheme, which is pretty good. Given the day that is in it the Senator might be willing to congratulate us on the fact, but perhaps not.