HSE Director General Tony O'Brien has told the Oireachtas Health Committee that the assessment procedures used to determine eligibility for medical cards and GP visit cards have not changed.

Referring to reports about the withdrawal of 'discretionary' cards (cards not based on income guidelines but on hardship) from seriously ill people, Mr O'Brien told the Committee the applications process for cards is now applied 'equitably and consistently', with medical officers assessing medical evidence for cost and necessary expense.

Mr O'Brien said he would like to reassure existing medical card holders that the HSE would not be changing its medical card eligibility assessment guidelines.

Health Minister James Reilly told the Committee that a recent review of discretionary medical cards had shown almost half of recipients were 200 per cent above the income guidelines.

He told the Committee that in March 2011 there were 97,121 holders of discretionary medical cards and of these, 39 per cent currently still held their discretionary card, with 43% moving to a normal means-assessed medical card based on a calculation of means.

The number of people who had been deemed ineligible for either a GP visit card or a full medical card was 6.5% of those who held a discretionary card in 2011.

Mr O'Brien told the Committee that the HSE had a cumulative net deficit of €75 million at the end of July.

The Committee was also told the HSE has appointed a team to implement the recommendations of the three enquiries into the circumstances surrounding the death of Savita Halappanavar.

Mr O'Brien told the Oireachtas Health Committee today that the team, being chaired by Director of Acute Services Ian Carter, would oversee the recommendations of the coroner inquest, the HSE's own review, and the recently-published HIQA inquiry.

Meanwhile, Health Minister James Reilly also said today he had mandated that four national clinical guidelines should immediately be commissioned and quality assured through the National Clinical Effectiveness Committee as a matter of urgency.

These guidelines are a National Maternity Early Warning Score Guideline, a National Paediatric Early Warning Score Guideline, a National Sepsis Management Guideline and a National Clinical Handover Guideline.

"The latter two guidelines will ensure the implementation of a number the key patient safety recommendations in the recent HIQA Report into the death of Ms Savita Halappanavar at University Hospital Galway," Dr Reilly said.

Doubt on medical card cull projections