Department of health officials have been instructed to draw up options for the return of discretionary medical cards to people who lost them in the recent contentious review.

The Cabinet sub-committee on health has instructed the officials to consult with the attorney general’s office and to draw up options for returning the cards “as soon as possible”, a spokesman said today.

He warned it would not be “a simple matter” because of the legal issues involved in returning a benefit to people who have been refused it.

Minister for Finance Michael Noonan confirmed this morning that discretionary medical cards will be returned to some people who lost them.

Mr Noonan said that following extensive Cabinet discussions it had been agreed that Minister for Health James Reilly would bring proposals to return certain cards. The review was abruptly halted last week.

“There was a long discussion on medical cards in Cabinet yesterday. The Minister for Health is bringing back detailed proposals to Government and one of them will deal with the return of medical cards for some of those people who lost them,” Mr Noonan said.

The Health Service Executive said the process of extending eligibility for those who were undergoing a review or appeal has commenced. This follows last week’s decision to suspend review of discretionary medical cards.

It said those affected were being notified through the normal routes, including text message.

As for people who have already lost their cards following a review, it said there was currently no legal basis for restoring eligibility.

“Identifying the appropriate legal and legislative measures required to provide medical card eligibility on the basis of medical need will be undertaken as part of the review of the legislative framework, supported by the work of the expert panel currently being established by the HSE.”

Sinn Féin leader Gerry Adams said the Government should announce medical cards will be restored to all who need them.

“They should make a public announcement saying that they have reversed that decision. It is not fair the way it is being eked out with some citizens getting a text that their medical card has been restored for their children.

“That leaves thousands and thousands of others wondering. The Government should just stand up, say it has reversed this policy and that medical cards will be restored to all citizens in need.”

Minister of State for Public Transport Alan Kelly welcomed the Government move on medical cards.

“I believe that an awful lot of work needed to be done on that. It was certainly one of the few major electoral issues that caused us the most difficultly in the local and European elections,” he said.

“I think it’s very regrettable that it was’t dealt with sooner. Some of the decisions in relation to medical cards were scandalous and you can’t stand over them. Disgraceful.

“I think the centralisation process has caused a number of problems. I’m delighted with the decision of the Government to make the changes that they have made in the last few days and I look forward to possibly even more changes in the near future.”

Asked if he agreed with some Fine Gael backbenchers who are calling for Minister for Health James Reilly to be replaced with a “fresh face”, Mr Kelly said: “Well certainly I believe that fresh faces in Government I think are a priority, full stop, but that would be a matter for the Taoiseach and whoever’s elected as Tánaiste.”

Earlier, Minister for Communications Pat Rabbitte said there had been " an explosion in the number of medical cards available and beyond that it's a matter for the Minister for Health."

Both Fine Gael and Labour backbenchers had reported that medical cards was a huge issue on the doorsteps ahead of the recent local and European elections.

Minister for Transport Leo Varadkar speaking this morning said many holders of discretionary medical cards were upset and frightened by the Government review which resulted in medical cards being withdrawn from some “very sick people” and some “very disabled people”.

Speaking to reporters in Dublin, Mr Varadkar said the HSE would now begin to examine how people may have their cards restored now that the review has been suspended.

“Over the next week or two the HSE is going to examine options as to how cards might be restored on medical grounds, or might in future be issued on medical grounds,” he said.

Mr Varadkar said he did not think anyone “with a sense of humanity would begrudge a medical card” to those whose conditions showed they deserved it, even if they were above the income thresholds.

“In the process a lot of people were upset even though in 96 per cent of cases their cards weren’t removed. They were upset by the process and frightened by the process in many cases...in some cases we saw cards removed from very sick people and very disabled people who may well have been above the income limit. But I think anyone with a sense of humanity wouldn’t have begrudged them the medical card.”

He said the difficulty was that “at the moment – in law – people can only get medical cards on the basis of low income not on the basis of medical need”.

The Minister also defended the “first principles” which gave rise to the review and claimed 96 percent of people who were subjected to a review did not lose their cards.

“I think it is important to go back to first principles and remember why the review of discretionary medical cards was done in the first place,” he said.

“There was a lot of inconsistency when it came to discretionary medical cards. Somebody in Meath for example was six times less likely to get a medical card than in Cork.”

He continued: “It was found that quite a number of people who had discretionary cards were deceased, in some cases they had left the country and, of course, doctors were still being paid for those people”.

Asked if he believed the review was a mistake in the first place, Mr Varadkar said there was never a “wholesale” withdrawal of the medical cards and emphasised that some 96 percent of cases reviewed resulted in the medical cards being retained.