As the Deputy is aware, prior to mid 2011, the medical card scheme was operated locally in approximately 100 administrative centres throughout the country which, until 2005, were managed by 10 different autonomous health boards. This model gave rise to the application of a non-standard approach when the element of discretion was used in the decision to grant a medical card. The different treatment of cases depending on their geographical location, is fundamentally discriminatory, an undesirable administrative practice and contrary to fair or sound administration.
The centralisation of medical card processing was completed on 1 July 2011. This meant that all new medical card applications and reviews made from 1 July 2011 were processed centrally by the PCRS Office in Finglas, Dublin. Centralisation delivered a consistent and equitable application of eligibility and service provision and has provided clearer governance and accountability, as well as improved management information. It is in the context of the finalisation of the centralisation project - 1 July 2011 - that the Government decided that the HSE would issue cards to persons, with a serious illness, whose discretionary card was refused renewal in the period from 1 July 2011 to 31 May 2014.
It should be noted that the provisions of the Health Act, 1970 (as amended) have not changed and that all applications for a medical card continue to be assessed against the HSE's National Assessment Guidelines. The HSE is continuing to assess and issue medical cards where discretion has been exercised to people to avoid undue financial hardship. In the event of a change in circumstances for those who had the renewal of their eligibility refused, they can submit a new application to PCRS.