I thank the committee for the invitation to attend today's committee meeting. I am joined by my colleagues, Mr. Paddy Burke, from primary care reimbursement services, PCRS, and Mr. Dave Moore.
The primary care reimbursement services section manages a wide range of primary care services across 12 community health schemes, including the medical card scheme, for a population of over 3.4 million people. These services are provided by more than 6,660 primary care contractors and involve 77.9 million transactions annually at PCRS, with an associated expenditure of €2.5 billion. As of 1 April 2012, there were 1,758,774 medical cards and 126,449 GP visit cards in circulation. That is an increase of 151,991 on the January 2011 figure. Comparing the figure to that of 2005, there has been an increase of 740,140 cards in circulation, or 65%. In 2011 a major change programme was initiated, planned and developed by the HSE to centralise medical card application processing in the primary care reimbursement service, PCRS, effective from 1 July that year. The purpose of the centralisation project was to provide for a single uniform system of medical card application processing, replacing the different systems previously operated through more than 100 offices across the country; to streamline work processes and reduce the number of staff involved in medical card application processing from approximately 450 to 150; to ultimately ensure a far more accountable and better managed medical card application processing system. I have circulated to committee members a written report on the medical card centralisation programme. The report sets out in greater detail the progress made since centralisation and also since the committee visited the PCRS in March.
I will confine my opening remarks to a short update on a number of key matters addressed in the report which will be of particular interest to the committee. Centralisation commenced in July 2011. This was a very significant change programme which involved the redeployment and training of significant numbers of staff and considerable changes to processes which had not been standardised previously. While considerable progress has been achieved in improving the medical card system, it must be acknowledged that during the first six months after centralisation, a significant backlog in processing applications accumulated. This caused difficulties for applicants which the HSE very much regrets. During February 2012 the HSE conducted a planned review of the first six months of the centralised operation. One of the first actions taken was to address the backlog of applications received between July and December 2011, which stood at 57,962 in January 2012. This figure includes applications which were incomplete, as well as those which were complete. The backlog was successfully cleared to zero by the end of April.
As part of the six month review, PricewaterhouseCoopers, PwC, also undertook a high level assessment of possible excess registrations on the medical card register. In its analysis PwC indicated a range of potential exposures if such excess registrations were to be substantiated; however, it also stated this preliminary assessment should be treated with caution and that it was only indicative in nature. A forensic analysis of the medical card database is under way and this analysis is scheduled to be completed by the end of August. The committee will also be aware that the Committee of Public Accounts has raised the issue of payments to general practitioners, GPs, in respect of deceased medical card holders. The HSE is undertaking a comprehensive analysis of the historical overpayments of €1.48 million referenced by the Committee of Public Accounts. This analysis will be completed by the end of May, following which the issue of overpayments will be followed up with GPs.
The report which has been provided for the committee also describes the significant programme of work under way to implement the recommendations of the review. In particular, we are improving the experience of service users through initiatives such as simplifying the application form and guidelines and enhancing the online application process; streamlining other medical card processes such as standardising the period of eligibility, simplifying the emergency medical card and medical card renewal processes to make them more customer friendly; improving the overall controls in place for such a significant level of State expenditure; appointing a new head of customer services to the PCRS who will take up the post in the middle of June.
While there have been some teething problems, most have now been addressed and the medical card centralisation project is proving to be a success. A total of 96% of completed applications and reviews are processed within the target 15 day turnaround time. As indicated to the committee at the last meeting, the statistics for medical card application processing are published weekly on medicalcards.ie. I am confident that the improvement initiatives which are being progressed and which my colleagues, Mr. Burke and Mr. Moore, can further outline will deliver a more streamlined and user friendly service to the public. I take the opportunity to thank the committee for its continued support of the HSE’s efforts to improve the medical card system and, in particular, we appreciate the time taken by the committee to visit the PCRS in Finglas last March. My colleagues and I will endeavour to answer questions members of the committee might have.