The Comptroller and Auditor General has said available evidence suggests that there is a material level of ineligibility in the medical card scheme.

However, Seamus McCarthy told the Dail Public Accounts Committee today that the exact financial cost to the State of people who were ineligible for cards under present guidelines currently holding medical cards had not been established.

He said a consultants' report last year had identified the cost of this excess expenditure at between €65 million and €210 million but this report had been limited in its scope.

This figure has been used as a benchmark by Health Minister James Reilly for his planned 'probity' review of current medical cards, announced in the recent Budget. His Department has set a target of €113 million for medical card savings next year.

However, HSE Director General Tony O'Brien said the figure of €113 million would not change people's eligibility criteria, and the figure was an estimate of the savings that could arise from measures designed to ensure probity on the medical card scheme. He said it was not a target for cuts.

Health officials at the meeting claimed there had been no change of policy in respect of medical cards.

Mr McCarthy outlined how the C&AG's office, through spot-checks on the granting of medical cards, had identified levels of ineligibility. In one sample, it had been found that 4% of cardholders checked did not satisfy eligibility criteria.

The C&AG told the Committee that he had asked the HSE to carry out checks on random samples of medical cards to check on whether holders of cards met eligibility criteria.

Committee Chair Kieran O'Donnell queried why there had been such an emphasis on reviewing eligibility for discretionary medical cards, usually held by people with serious illnesses, when these cards only made up around 0.3% of the 1.8 million medical cards held at the moment.

He suggested that it would be better value for the taxpayer to look instead at other areas such as checking on the number of general medical cardholders who may be deceased.

Paddy Burke, head of the HSE's medical card service, said the HSE would have reviewed 600,000 cards by the end of the year. Within three years, he said, the entire medical card database would have been reviewed.