HSE service plan cuts may cost thousands of medical cards

Cost savings outlined in the HSE’s draft service plan for next year are likely to lead to the loss of thousands of medical cards next year, according to health sector sources.

The HSE was last night due to hand over its spending plan for the coming year to Minister for Health Dr James Reilly which will set out in detail where cuts of at least €666 million will be made.

For the first time, officials from the Department of Public Expenditure and Reform and the Department of the Taoiseach will be involved in scrutinising the draft plan. This is aimed at preventing cost over-runs which have dogged health spending in recent year.

Neither the HSE nor the Department of Health were prepared to comment on the contents of the spending plan before its publication.

A spokesman for Dr Reilly said a key priority would be to maintain frontline health services at a time of rising demand as a result of the ageing population and high birth rates.

However, thousands of people are likely to lose medical cards next year as a result of a more thorough assessment of recipients' incomes, as well as changes to eligibility thresholds. For example, the income threshold that applies to over-70s medical cards will fall from €600 to €500 per week.

Threshold
The threshold for a couple is being changed from €1,200 to €900. Some 35,000 people affected by the measure will in future qualify for a GP-visit card rather than a full medical card.

Medical card entitlement is also being changed for those returning to work. Henceforth, people re-entering the workforce will be entitled to a GP-visit card for three years, rather than a full medical card.

In many respects these savings will mirror the 2013 service plan. This stated that policy changes would lead to a reduction of about 40,000 medical cards as a result of changes to income calculations.

In the recent budget, Dr Reilly said a specific target saving of €113 million had been earmarked as part of a “probity” drive for 2014 involving closer scrutiny of eligibility for medical cards.

One health source yesterday indicated it would be a stretch to reach savings of this magnitude, which may place pressure on other areas of health spending.

The other main area of focus will be on how frontline health and social services may be affected as a result of spending cuts over the coming year.

In the area of disability, it is understood that discussions over the spending for the coming year have proved positive and groups are cautiously optimistic that frontline services will be maintained.

Voluntary hospitals claim that they have been doubly affected by funding cuts resulting from the economic downturn and "disproportionate" reductions in the hospitals budget compared to other programmes.

Further savings
The EU-IMF troika has said that further savings can be made in the health system without affecting services to patients.

It has singled out cost of patented and generic medicines as being unacceptably high despite the measures taken by the Government to reduce costs

While capital expenditure has been regarded by many as an area that may be targeted, Dr Reilly has said there is no question of this being cut.

He said recently that projects including the new national children's hospital, the relocation of the National Maternity Hospital from Holles Street to St Vincent's Hospital campus and the planned move of the Central Mental Hospital from Dundrum to Portrane were priority issues.