HSE weighs up medical card freeze until 2012

THE HEALTH Service Executive may suspend issuing medical cards as part of a raft of drastic measures aimed at breaking even in 2011.

Along with the proposed suspension of issuing new cards, draft proposals show the HSE is considering reducing home help hours by 600,000 – or 24 per cent – and removing 400,000 personal assistant hours – 61 per cent – between now and year-end in cuts that will save €57.5 million.

The internal document shows the HSE is considering not issuing any new medical cards to a projected 42,044 people under 65 – except in emergency cases – between now and the end of the year in order to save €18 million.

The document states that to date this year, the HSE has issued 84,088 new medical cards to those under 65 and anticipates that 126,132 will be issued by year-end without the cuts being made.

The HSE is also considering suspending medical card reviews and providing no further appliances or aids to patients for the remainder of the year to save €6.5 million.

The document acknowledges that these measures “are substantial and radical with significant policy and legal implications and will require discussion with the Department of Health before implementation”.

The document on “proposed reductions that will have an immediate cash-flow effect” comes against the background of the HSE having to generate savings of more than €300 million before the end of the year.

In a commentary accompanying its monthly service report for the year to July, it said it was pursuing savings targets of €249 million as well as further contingency measures of €53 million to support the delivery of a balanced budget.

The reduction of 600,000 home help hours between now and the end of the year will produce savings of €11 million and cutting 400,000 personal assistant hours would save €10 million.

The document says the 24 per cent reduction in home help hours will result in increased demand on the acute sector and for long-stay care; will lead to an increase in the number of delayed discharges and waiting lists; will impact on trolley waits; and will impact on the ability to keep old people at home.

In relation to the 61 per cent loss of personal assistant hours, the document concedes it “will result in increased demand for respite and residential care”.

The draft proposals also put forward the reduction of 200 homecare packages that will save €1.1 million and a proposed 2.5 per cent reduction in funds to voluntary providers that would save €9.3 million over three months.

The paper acknowledges that the cut to voluntary providers “may impact on services provided by voluntary organisations – potential reduction in day service activity, particularly in rural areas and reduction in activities provided at centres”.

Fianna Fáil health spokesman Billy Kelleher said last night that the proposed cuts “will have the most profound implications on the most vulnerable and most needy”.

Chief executive of the Irish Patients’ Association Stephen McMahon said “the HSE must carry out a patient impact statement” on its proposals.