Proposals to severely restrict the awarding of discretionary medical cards by the HSE were put forward for consideration by ministers as early as the run-up to Budget 2010.

However, members of the cabinet at the time were warned that changes to primary care schemes were “very high risk”.

The current Government suffered enormous damage last year as a result of the controversy over the withdrawal of medical cards on foot of a HSE review.

In June last year, Taoiseach Enda Kenny apologised to people who had had their cards withdrawn. He told the Dáil that many people had suffered unnecessary stress as a result of a review of discretionary medical cards.

€130 million savings

However, newly released cabinet papers from October 2009 show that ministers in the previous Fianna Fáil- Green coalition were given proposals at that time for generating savings of up to €130 million by revising income guidelines and introducing targeted changes in respect of some categories, such as young single adults and discretionary cards.

The memorandum on the potential savings, put forward by the Department of Finance, also contained an evaluation paper drawn up by its officials containing more details on specific options.

While eligibility for medical cards was based on income, the paper said, HSE deciding officers had additional discretion to award them.

“In practice under these arrangements, all people whose sole income is from social welfare automatically qualify for a medical card regardless of medical need and there are significant numbers of middle income earners in employment and single people rather than families with medical cards.”