€113m medical card savings not ‘target but estimate’

The €113m savings sought through “medical card probity” announced in the budget is not a target but an estimate of what can be achieved, according to the HSE chief executive, Tony O’Brien.

He confirmed that the Government has granted a further 10-day extension to provide its service plan for 2014, saying that devising where the cuts will fall has been “more complex” than in previous years.

Mr O’Brien, who has cast doubt over the possibility of reaching €113m through finding waste in the medical card system, once again distanced himself from the figure.

“It was decided by the Government and published in the estimates. It was not proposed by the HSE,” he told the Dáil’s Public Accounts Committee, which monitors government spending.

And he said it was not a “pre-cooked” figure which will result in a clampdown on medical card entitlements.

“It is not a target for cuts. It is an estimate of what might be obtained as a result of a probity exercise,” he said.

It is estimated that the figure would result in a reduction of 100,000 medical cards in circulation.

However, Mr O’Brien said such predictions have caused fear: “It would not be wise or prudent or in the general interest to be speculating what the outcomes would be.”

The HSE confirmed that more than 6,000 people had lost their discretionary medical cards so far this year as a result of assessment of eligibility, but insisted there had been no change in policy on the issue.

There was a “cultural issue to deal with”, Mr O’Brien said, adding that the belief that people should be given medical cards on the basis of their medical condition is “only being challenged now”.

He said it was never the case — under the Health Act of 1970 — that illness qualified a person for a discretionary medical card, but rather it would be taken into account when calculating whether the cost associated with their illness caused them “undue hardship”.

The HSE head of primary care, John Hennessy, said there were a “significant number” of parents of children with Down’s syndrome who have raised concerns about the loss of their discretionary medical cards in the past two to three weeks.

However, he said if there were additional supports these families were entitled to under the Disability Act then they would be available.