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Annual Report of the Ombudsman 2004

Chapter 2 - South Western Area Health Board - Medical Card

It is important that, in their dealings with elderly people, public bodies are particularly careful that they provide them with accurate information on their entitlements and that proper internal record keeping procedures are in place so that advice provided to the elderly, and the public generally, is accurately recorded in case of subsequent disputes. This next case involving the South Western Area Health Board illustrates these points.

A woman complained to me on behalf of her father who was given incorrect information by the South Western Area Health Board about his entitlement to a medical card.

The man applied for a medical card to the Board in December 2000. He subsequently made a telephone enquiry about the status of his application and was informed, based on the information he had given on the telephone, that he would not be eligible on income grounds as his pension from the UK was in excess of the income guidelines.

Over a year later, he found out from a friend that he should be entitled automatically to a medical card as he was in receipt of a British pension. In this regard, pensioners living in Ireland who are receiving a social security pension from another EU State, provided they are not regarded as employed or self-employed here and do not receive an Irish social welfare pension, are automatically granted a medical card without having to undergo a means test.

The complainant submitted another application in July 2002 pointing out that he was in receipt of a UK pension and he was granted a medical card for himself and his wife. Shortly afterwards he applied for a refund of expenses he incurred under the General Medical Scheme from the time he first applied for the Medical Card in December 2000 up to the time he was granted it in August 2002. This was refused by the Board and the Appeals Officer on the grounds that there was no record of the first application which he said he submitted to the Board in December 2000. In addition, there was no record of the subsequent telephone calls which he and his daughter made to the Board about the matter.

Following my examination of the case it emerged that there was no system for logging telephone calls in respect of queries received from individuals about medical card applications. The Board subsequently reviewed its decision and issued a refund of the qualifying medical expenses incurred by the complainant for the relevant period which amounted to €1,851. The Board has also introduced a form for recording details of telephone calls about medical card applications.

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