HSE audit urges review of medical card processing facility

An independent value for money review of the Health Service Executive’s centralised medical card processing facility should be carried out, according to a new report.

The HSE’s internal auditors say it is now timely for a review of the service, which took over the processing of medical card applications from local health offices in 2011. The review would determine the extent to which value for money is being achieved and would also quantify the efficiency of the service for patients.

However, the auditors’ call for a review is being resisted by the HSE, which says there have been at least seven external reviews of the area in recent years.

Previous reports calling for tighter controls on medical cards led to claims the HSE was “scaring” the sick. And an increase in the rate of card reviews was interpreted as a cost-cutting exercise. The issue damaged the Government politically, and the number of discretionary cards awarded increased.

In the latest report, the auditors also call for regular reviews of dormant medical cards and regular random full reviews of all categories of cards to ensure eligibility conditions are being complied with.

Self-assessment

It says cards issued on a self- assessment basis should be fully reviewed each year and the Primary Care Reimbursement Service (PCRS), which administers the medical card scheme, should liaise with the Revenue Commissioners to check income details with applications.

In response, the HSE says risk in the area is fully managed, and 100 random full reviews and 100 self-assessment reviews are carried out each month.

The HSE should adopt a formal protocol governing the granting of medical cards on a discretionary basis, it says. Cards with expiry dates longer than the standard three- and four-year periods of issue should be subject to review so uniformity can be achieved.

The HSE says there are 53 cases where eligibility extends beyond five years and these are being addressed.

The report also makes a number of recommendations particular to staff at the PCRS facility.