A report by management consultants into the way the Health Service Executive operates the medical card review process says it has been hampered by limited resources and is a 'flat organisation', with a small number of deciding and medical officers.
The report, by consultants Prospectus and Deloitte, says that the application and review process is largely paper-based and in future should be administered electronically.
But it also says that some GPs seem unaware of their authority to extend medical card entitlements and some patients can first learn that they are no longer covered, when they arrive at the family doctor or pharmacy.
The report says that the HSE review process does not link in with other Government systems, resulting in requests for duplicate information, leading to errors and frustration.
It calls for a simplified single application process for a medical card, GP visit card, the Long Term Illness and Drugs Payment Schemes.
It also says there should be clearly defined and documented operating policies and procedures for applications because there is inconsistency and ambiguity in administering the current process.
The level of information captured by staff is also inconsistent.
However, it also says the centralisation of the medical card application process has saved the taxpayer around €80 million over the last three years.
Around 90% of people who engage with the system have a positive outcome and most applications, where complete information is supplied and are approved, are processed within the deadline of 15 days or less.
