A REPORT ON medical cards in Ireland says that the HSE’s extensive reviews of the cards made people afraid.

The Public Accounts Committee (PAC)’s report also said it is “gravely concerned at the waste of money of the current extensive reviews, given the known level of eligibility in the system”.

The report, which can be read in full here, has a number recommendations for the HSE around medical cards.

Meanwhile, RTÉ reports that an unpublished report has concluded that it isn’t possible to identify medical conditions to be considered when determining if someone is eligible for a medical card.

The number of cards in circulation at the end of 2013 was 1,987,933, which equates to 43% of the population.

The PAC said the increase in the number of medical cards coincided with the economic downturn since 2008.

Medical card reviews

By the end of 2013, the HSE had reviewed almost 1 million card holders. It is proposed that the entire medical card population will have been reviewed by the end of this year.

In 2014 and arising from a huge negative reaction by the public, the Government stalled the review of those medical cards that were allocated on a discretionary basis.

In its report, the PAC said that a “fear emerged in the card holding population” due to the reviews.

It said that:

That reaction and the fact that many vulnerable people associated the review with losing their entitlement is an issue that needs to be addressed in future reviews

It said that the HSE needs to tailor the letter writing style to the targeted audience, “many of whom are elderly and vulnerable due to illness”.

The PAC believes the HSE “needs to examine the extent of the burden that is placed on many card holders, some of whom are old, sick and may not have the ability to understand forms or to gather information to effectively re-apply for their medical card, which they had become so dependent on”.

Discretionary cards

On the withdrawal of discretionary cards, the PAC said that “the matter should have been handled in a more delicate fashion by the HSE given the fact that many of these cardholders were initially granted a card because of their long term medical condition”.

The PAC also said the HSE must work harder on risk profiling so that compliant medical card holders are not subject to extensive review.

The report suggests that a more robust system of risk profiling can be delivered through better use of the HSE’s centralised database, which contains information on the almost two million card holders.

It says that a comprehensive risk profiling system should be developed at the HSE’s Primary Care Reimbursement Service as a matter of top priority.

The key recommendations include:

• Medical card holders who have a high risk profile should be priorities for review purposes.
• Given the evident anxiety of the medical card holding population arising from the review process, the HSE should review its communication strategy and engage in a public awareness campaign to coincide with any future reviews.
• The HSE should examine ways of extending medical cards automatically for the 80% plus cohort of card holders, whose eligibility is in little doubt, because of their low risk profile.
• The HSE should review its control procedures to devote the majority of its available resources to the initial award process and to the focused reviews.
• In the case of people with a long term medical condition or disability the HSE should compare the costs of granting them a medical card as against reimbursing their costs under the long-term illness scheme.
• The HSE should do a random audit of its medical card base which will give an indication of the extent of excess payments.

Read: Parents of sick children angry over Varadkar’s comments about medical cards>