Restoring 13,300 discretionary medical cards* cancelled in HSE reviews will cost an estimated €13 million, Taoiseach Enda Kenny has told the Dáil. He also apologised for the distress caused by the HSE review of cards. “I’m very sorry that many of the cases brought to light really did cause a great deal of stress for people,” he said.

Confirming the restoration of cards to about 13,300 people, Mr Kenny said each discretionary card cost €1,130 a year and 5,288 discretionary full medical cards were refused renewal of any form of card.

In addition, 7,118 full medical cards were replaced with a GP card. Their reinstatement cost is €880 a card, he told Fianna Fáil leader Micheál Martin. He added that 2,899 discretionary GP visiting cards were refused and reinstating them would cost €250 each.

Mr Martin questioned the numbers and said “too much playing around with the figures is going on”. He claimed 30,000 medical cards were taken back and asked what happened to the other 15,000 that were not being returned.

Mr Kenny said "the vast majority of cards were reawarded to people". He added that the HSE director general could act on his discretion to take account of an ad misericordiam appeal on a case by case to replace a discretionary card "where, due to exceptional medical circumstances, a person did not respond or reply to a review or repeal system".

He said about 10,000 card holders did not respond to or complete the review process, “neither did approximately 4,500 discretionary GP card holders”, but he did not know the numbers who might qualify under that process.

The estimate was 13,300 cards to be restored at a cost of €13 million, the Taoiseach concluded. These were cards where discretion was applied since July 1st 2011. Medical card holders should get them back in the next four weeks and he reiterated the suspension of the review of medical cards.

Pressed by Sinn Féin leader Gerry Adams, Mr Kenny said the €13 million cost to restore the cards would not be taken from frontline services. “The Government decided today that this will be dealt with later,” he said.

He repeated his regret at the distress caused to families. In centralising the medical cards system because of the inequality in discretionary card assessment across the State, “clearly significant numbers of families where there were children in particular with complicated medical circumstances were very badly stressed. I regret that very much.

Mr Adams said he did not understand how, when the decision was made to remove medical cards, “someone did not have the wit or the social conscience to ask what the likely consequences would be”.

The restoration of some medical cards had been described as a temporary decision which he asked the Taoiseach to explain. Mr Kenny said the application of discretionary card analysis was implemented in a very uneven fashion and “in an unfair fashion”. In some cases cards were issued with very little analysis and in others “with very stringent analysis”. Equalising the process resulted “in many thousands of people being severely affected”.

*While the Taoiseach used the figure of 13,300 medical cards restored, the HSE figure is 15,300