Up to 75,000 face losing medical card

Up to 75,000 medical card holders will be stripped of the vital support from January — including 25,000 who will lose out as a direct result of the HSE’s highly controversial “probity” review.

Half of all cards currently in place will also come under intense scrutiny as part of a “risk assessed” review of 1m people receiving the support.

The details are revealed in the HSE 2014 Service Plan which, despite confirming the cut will “save” €23m instead of the previously planned €113m, has outlined exactly what problems card holders face next year.

Under the move, 20,000 to 25,000 people will lose the help as a result of the review. A further 30,000 over-70s will lose their cards as a result of new income eligibility outlined in the October budget.

In addition, the HSE has issued a target to cull 20,000 more cards held by people who have emigrated, died, or are no longer considered to be in need of support.

The HSE attempted to soften the impact of the hit by stating 60,000 more cards will come on stream next year for any new applicants, meaning the net fall between 2013 and 2014 will be 15,000 cards.

However, the proposed card cull is likely to cause fresh concern among patients and doctors who have seen at first-hand how the cuts have been imposed on the system.

HSE director general Tony O’Brien said the cuts could have been far worse if the initial October budget plan had been imposed.

Two months ago, Finance Minister Michael Noonan revealed the HSE must cut €133m from its medical card budget for 2014. The rate was imposed after tense discussions between Mr Noonan, Public Expenditure and Reform Minister Brendan Howlin, and Health Minister James Reilly in the days before the budget was announced. In the subsequent two months, Dr Reilly made it clear such a reduction would have a significant impact on patient care, resulting in the Service Plan’s publication being repeatedly delayed.

After a draft was sent by Mr O’Brien to Dr Reilly earlier this month seeking the cuts to be reduced to at least €113m, the minister met with Mr Noonan, Mr Howlin, Taoiseach Enda Kenny, and Tánaiste Eamon Gilmore on Monday in a bid to further reduce the cut.

This led to a deal to lower the medical card cut to €23m, with the majority of the gap made up from a €47m transfer from social welfare due to reduced unemployment levels and a decision to take €63m from the HSE’s pension budget next year.

The Service Plan stressed the pensions transaction “is not without risks” as there may not be enough money for retiring staff. However, Mr O’Brien insisted the original medical card cuts rate is now “off the table”.