Up to 50,000 medical cards will be cut this year - HSE
Between 30,000 and 50,000 medical cards will be cut this year due to more people getting a job as well as reviews of eligibility and retention criteria, a new HSE report has revealed.
It comes as the HSE said one of the "threats" its medical card unit faces is the representations made by TDs on behalf of constituents applying for a medical card.
There is a perception that a medical card, which is based on set eligibility criteria, will get more "favourable assessment" if a TD makes a representation, it said.
It was originally planned to cut the number of cards by 125,000 in 2016 - but this was scaled down after the Cabinet late last year raised concerns about the proposed extent of the cuts.
It was prompted by fears another row, similar to the bitter controversy over cuts in discretionary medical cards, would erupt before the General Election.
Other threats identified by the HSE include fraudulent data submitted by applicants for medical cards and a "change in government policy and political landscape".
This is in reference to the differing policies of the main parties to universal healthcare benefits such as GP visit cards with no means test.
The issues are outlined in a draft document on the future development of the HSE's centralised medical card unit which is now out for public consultation until April 6.
It pointed out that there are currently two million people with medical or GP visit cards.
"When looking back over the past decade, there was a continued growth in the number of medical card holders.
"Between 2004 and 2015, the number of people with medical card and GP visit cards has risen from 1.4 million to 2.17 million, which is an increase of 90pc in 10 years," said the report.
The extension of GP visit cards to all under-sixes last year led to a take-up by 210,000 parents in the first six months.
Future numbers will be influenced by factors such as the increase in the population aged over 65 to 909,000 by 2026 and the over 85s to 104,000.
Previously local health offices around the country were responsible for issuing medical cards. However, in 2011 the process was centralised in Dublin.
This single system is one of the strengths of the scheme, but the processing is also heavily manual and involves large volumes of paper, said the report.
While it means there is one dedicated centre available to the public, there is also public and political criticism of the scheme.
The report described the challenge faced by the medical card unit in providing a quality of service as "continuous and unyielding".
Part of the new plan is to involve representatives of the public having an input on major issues, particularly "ethical and social issues".
Anne Marie Hoey of the HSE's medical card division said people who want to take part in the consultation can complete a survey online at www.hse.ie.