THE discretionary medical cards "lottery" has resulted in major differences between the numbers issued in different counties, new figures reveal.
North Tipperary has seen the biggest drop in people with discretionary medical or GP visit cards since 2012 – a fall of 52pc.
However, numbers with the benefit in Meath during the same period went up by a massive 138pc, the figures supplied by Junior Health Minister Alex White revealed.
While a range of factors have impacted on the figures, the centralisation of the medical card system in Dublin, which took decision-making from local offices, has meant some parts of the country are particularly badly hit.
Others areas that have seen a significant drop include north Wexford, north Cork, west Cork, Dun Laoghaire and Dublin southwest.
Areas of the country that have seen a rise are Louth, Dublin south city, north Dublin, Dublin south east, Galway and Mayo.
Health Minister James Reilly has said he supports the centralisation of the medical card system because there was a lack of consistency in the way discretionary cards were being issued previously.
However, the stripping of discretionary cards from thousands of people has led to allegations that patients with particular needs due to disability and serious illness are falling through the cracks as the system has become more impersonal and bureaucratic.
The figures, which were supplied to Labour TD Ger Nash in a parliamentary reply, come as the Health Service Executive (HSE) confirmed yesterday it is outsourcing some of the administration functions of the medical card scheme to the Dublin-based German firm Arvato.
Dublin North TD Clare Daly told the Dail that the outsourcing may explain some of the "bizarre" decisions being made on medical cards.
However, the HSE said the firm provides "data-entry services only" and all decision-making in relation to eligibility for services is carried out by "HSE staff only with oversight by HSE medical staff".
A spokesperson for the HSE refused to reveal how much it was paying to outsource the work, saying it was selected by an open tender process. Fine Gael TD Jerry Buttimer, the chair of the Oireachtas Committee on Health and Children whose members visited the HSE's centralised medical offices in Finglas yesterday, said later that they had stressed the need for more compassion in whose cards are being processed or lost.
He said he was assured that the firm carrying out the outsourced work is not given any sensitive information about people's illnesses or other circumstances.
"Frank views were expressed and members recounted very difficult and emotive experiences of their constituents in relation to medical cards.
He said the committee also outlined their concerns, which included delays in processing of new applications, delays in the review process and reduction in numbers of discretionary medical cards.
A spokeswoman for Arvato said it could not comment on services it provides for individual clients and she referred questions to the HSE.