Thousands of people who lost their medical cards are to be given one-to-one advice on how to avail of other practical supports from the health service – but are unlikely to get the card back.
The HSE has outlined a series of measures which are planned to help those – many with profound disabilities and serious illnesses – who have had their cards removed. Between 2,000 and 4,000 people will get this one-on-one advice.
However, the proposal to provide packages of care to those people is expected to fall far short of demands by backbench TDs and the public as the majority will not have their discretionary cards restored.
The move follows the controversy over the removal of around 30,000 of these "discretionary" cards in recent years, which led to angry Fine Gael backbenchers challenging Health Minister James Reilly at a parliamentary meeting this week.
The discretionary cards are issued to people who are above the normal income thresholds but have a serious medical condition which can put them under financial pressure.
The minister yesterday confirmed he was exploring different options with the HSE to help people who lost the discretionary cards, saying it was important to ensure the system did not lose its "compassion".
This was interpreted by some TDs as a signal that the eligibility for cards would be relaxed, but this has been ruled out for now by the HSE.
John Hennessy – HSE's Director of Primary Care – said yesterday that it had been asked by the minister two or three months ago to look at what could be done for people with a profound disability or serious illness who lost their discretionary cards.
The aim now is to tailor a package on a case-by-case basis by directing people to existing services which they are entitled to anyway. This may involve giving them therapy or medical equipment. When the medical card system was centralised in Dublin in 2011 the cards were no longer issued from local health offices and this meant the personalised approach ended, leaving some people who had particular medical needs losing out on services, said Mr Hennessy.
It is now planned that if a medical card is not to be renewed the person would not just receive a formal letter but will be contacted by an official assigned to their case.
Mr Hennessy said a "significant number" of people who lost discretionary cards are getting them back on appeal.
But those whose incomes substantially exceed guidelines will not get them.