The number of people with medical cards has fallen by 65,000 in a year, according to new figures which appear to bear out claims that a “cull” of cards is under way.
The latest performance assurance report from the HSE also reveals massive increases in some waiting lists. An additional 30,000 patients have joined the outpatient waiting list in the last three months, while the number of people waiting more than eight months for inpatient or day-case treatment has jumped from four to more than 4,000.
The figures are likely to pile pressure on Minister for Health James Reilly in the aftermath of a disastrous election for the Government in which the medical card issue figured highly.
The pace at which medical cards are disappearing is accelerating, with a drop of more than 50,000 in the number of people covered over the first three months of the year, the March performance report shows.
The number of GP visit-only medical cards has also fallen, by about 5,000 between the end of 2012 and the end of March 2013.
By then, 1,799,103 medical cards had been issued, 76,000 fewer than the HSE itself projected. Some 49,596 of these were issued on discretionary grounds, a drop of about 1,000 since January.
An additional 120,981 people had GP visit cards, much fewer than the 161,000 target set by the HSE. Some 29,080 of these were issued on discretionary grounds, an increase of about 2,000 since January.
Waiting lists Outpatient waiting lists have grown for three months in a row after recording a sharp drop at the end of 2013. The total number on outpatient lists at the end of last year was 300,752, but this increased to 309,496 in January, 323,304 by the end of February and stood at 331,281 at the end of March.
The numbers waiting between one and two years for an outpatient appointment increased from 3,990 at the end of last year to 14,746 by the end of March.
The numbers waiting between two and four years for an appointment jumped from 903 to 1,437 between the end of December and the end of March. Some 112 patients have been on the outpatient waiting list for over four years.
The report links an increase in outpatient attendance to a “still less than optimal chronological booking process”.
There are 27,483 on University Hospital Galway's outpatient waiting list, 24,407 at Tallaght Hospital and 21,304 at Beaumont Hospital.
The longest lists are in the fields of orthopaedics (42,275) and ear, nose and throat medicine (37,318).
Meanwhile, the waiting lists for inpatient/day case operations and treatments continue to spiral.
Just four adult patients were waiting over eight months for treatment at the end of 2013, but this figure grew to 1,764 waiting at the end of January, 3,490 at the end of February and 4,350 at the end of March.
Children The number of children waiting over the target time of 20 weeks for inpatient and daycase operations and treatments increased from 193 at the end of last year to 821 at the end of March. Over the same period, the number of patients waiting for referral for a routine colonoscopy soared from 96 to 1,441.
Attempts to reach other key targets in the health service are in disarray. Over 63 per cent of patients at emergency departments are discharged or admitted within six hours, compared to a target of 95 per cent of patients. Almost 78 per cent are dealt with within nine hours, compared to the target of 100 per cent.
And while there was good news in the form of a 3 per cent fall in the number of patients waiting on trolleys in emergency departments, this was well short of the 10 per cent drop which was targeted.
The figures show that hospitals are busier than ever, with a 3 per cent increase in attendances at emergency departments and a 2 per cent rise in admissions. However, births fell by 1 per cent on the same period last year, further easing the pressure on maternity hospitals.
