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Medical Cards

Dáil Éireann Debate, Wednesday - 15 February 2012

Wednesday, 15 February 2012

Questions (4)

Billy Kelleher

Question:

4Deputy Billy Kelleher asked the Minister for Health the additional resources that will be assigned to deal with the backlog of medical card claims; and if he will make a statement on the matter. [8731/12]

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Oral answers (5 contributions)

I thank Deputy Kelleher for raising this issue as I know this is a matter of concern to all Members which I very much share.

Last July, the HSE centralised the processing of medical card applications and reviews at the primary care reimbursement service, PCRS, in Finglas, Dublin. The aim is to have a single uniform processing system to replace the different systems previously operated through more than 100 offices across the country. It is expected the new arrangement will ultimately provide for a far more accountable and better managed medical card processing system.

However, I am conscious there have been serious difficulties for many patients resulting from the centralisation process. For its part, the HSE has now accepted it needs to review the overall operation of the central office with a view to ensuring an acceptable level of service for the public is in place. This review is being assisted by a consultancy firm which will review current processes, develop proposals for improvements of the processes and for improvements in customer service.

Notwithstanding this review, I have had extensive discussions with the HSE on this matter. Several changes have been introduced to streamline operations and to make the process for renewing a medical card simpler and easier for the public. The HSE has introduced a self-assessment system for medical cardholders who are 66 years or over. The self-assessment review model has been extended to medical cardholders under 66 who were granted their medical card on the basis of a means assessment. The HSE is standardising eligibility periods from two years to three years for people aged under 66 with a new four-year eligibility period for medical cardholders aged 66 or over. It is providing GPs with a facility to maintain the eligibility of vulnerable patients going through the renewal system. To make the application process easier, the HSE has asked the National Adult Literacy Agency to review the medical card application form.

Additional information not given on the floor of the House.

An additional 20 staff were redeployed to the central office in January to bring its complement up to 150. The most important initiative, however, is that the HSE has decided that any medical cardholder undergoing a review, and who genuinely engages with that review, will not have their entitlement withdrawn before that review is complete, regardless of the expiry date shown on their medical card. In addition, the HSE has examined medical cards that were withdrawn between July and December 2011 to ensure a standardised approach to applications.

I am determined the HSE will comprehensively address all of the difficulties that have arisen as a result of the centralisation of medical processing in the shortest time possible.

I want to put on the record of the House my appreciation of the staff in the Minister's office and the HSE in dealing with individual queries concerning medical card applications. However, the system is in absolute chaos which must be addressed quickly.

For the life of me I cannot understand why a review of medical card eligibility must be carried out for those with incurable diseases. What circumstances are going to change? I met a woman who was blind but was asked for further information on the renewal of her medical card application. It is beyond belief that a system would have reviews of medical cards that we know will be granted again. I have no difficulty in people going through a due process when applying for a new medical card. However, those renewing a medical card who are suffering from an incurable disease should be exempt from these reviews. That would allow PCRS officials to deal with the existing backlog for new medical cards. I urge everyone involved to get to grips with this problem.

This week, I had a case of a woman who passed away on Monday morning but the PCRS was looking for further medical evidence from her during the week. The office dealt with it sympathetically but the system should not have allowed that to happen in the first place. Will the Minister resolve the backlog of medical card claims quickly?

When the case the Deputy just referred to was first brought to my attention on Monday morning when the parliamentary question came in, I dealt with it promptly. I too was concerned about the manner in which it had been dealt with. The errors made in that unfortunate response from the PCRS were not as a result of any policy change but human error. It should not have happened. I was concerned about it and I have a detailed report for Deputy Kelleher which I just received last night. I am happy to discuss it with him later on today. Applications made on behalf of patients who are terminally ill are supposed to be dealt with as matter of urgency and in a straightforward manner.

I put on the record my appreciation for the manner in which the Minister's office dealt with this matter. However, in general, there are many other issues with the medical card renewal process. The idea a person waiting for a medical card renewal can claim back medical expenses they incurred when it is re-issued is not happening. I have several cases where individuals have had to pay pharmacists for medicines because they were not allowed to backdate the costs incurred when they were in transition between their old medical card and the issuing of a new one.

Apart from the changes I outlined, an additional 20 staff were made available to the PCRS to bring it to its full complement of 150.

Members should be aware of the important provision that if a person engages with the HSE on the renewal process, he or she will not lose eligibility during that period. We are seeking to explain clearly that there will be no question of eligibility being withdrawn during the renewal process until such time as a decision is taken. I am requesting the HSE to produce an information sheet for Members, GPs, pharmacists and citizens information centres to bring people up to date on the current policy. I hope we will start to see improvements in the processing of medical cards as a result of these changes.

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