From the Irish Independent early this year.
HSE accused of a systematic cull of medical cards lists
[broken link removed]
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By Dearbhail McDonald Legal Editor
Friday February 01 2008
VULNERABLE patients are being "systematically deleted" from the Government's medical card scheme.
The [broken link removed] has learned that thousands of patients are being removed from the medical card list by the [broken link removed] because they are failing to return their review forms on time.
Medical cards are being deleted by the HSE prior to their actual review date -- in some cases they have been withdrawn a year before the official review date -- leaving patients who are entitled to free healthcare burdened with unnecessary costs.
Others are simply refusing to attend doctors' surgeries when they are sick, because they cannot afford to.
The first major study of the impact of the medical card review process has found that vulnerable patients, including those on low incomes, the illiterate, elderly and homeless, are being removed from the General Medical Services (GMS) list for non-return of review forms. The study, to be published in the 'Irish Medical Journal', has found that the gulf between eligibility for a medical card, and actual possession of one, is hindering access to healthcare for patients who need it most.
It found that 89pc of patients in a major [broken link removed] practice were removed for non-return of review forms.
But interviews with a random sample of deleted patients revealed that 60pc had not received a review form from the HSE, even though all patients believed they were still entitled to a medical card.
Withdrawn
In addition, 60pc of patients were not informed by the HSE that their medical card had been withdrawn.
The vast majority of patients later re-applied and obtained their medical card, but in the period without medical cover -- up to a year -- a third could not afford to see their GP and paid "out of pocket".
"There is a hole in the bucket," said [broken link removed], an inner city Dublin GP who led the IMJ study.
Dr Carroll, who had 1,489 patients deleted from the medical card list in just over two years, said that a minor change to the medical card scheme (patients are now reviewed annually instead of every five years) has resulted in those who are eligible for free healthcare having their entitlement withdrawn.
"This study shows that a bureaucratic policy change has negatively affected access to health care," he said.
"And it is precisely the people who are more likely to need free healthcare are less likley to return their forms".
The rate of medical card removal by the HSE could explain why the Government, which has increased income guidelines in an effort to expand eligibility, has consistently failed to meet its own targets to increase the amount of people on the medical card list.
It is the first time the link between the Government's own target and its deletion policy has been made.
Last night the HSE was unable to provide its deletion figures, but the Government has insisted that the question of medical cards for vulnerable families is a priority.
Some 1,276,178 hold medical cards, according to the HSE and an additional 75,589 are GP Only card holders.
- Dearbhail McDonald Legal Editor