Plans by Health Minister James Reilly to remove full medical cards this year from previously unemployed people who have recently returned to work have hit legal problems and the measure has not been implemented.

According to the HSE, the move, which was earmarked to save €11 million in 2014, is dependent on legislation, but it told irishhealth.com the legal basis in relation to this measure was currently being examined by the Department of Health.

The HSE says alternative options in relation to the measure were now being looked at.

Under current rules, a person who returns to work after a period of unemployment can retain a full medical card, giving them free GP care and free medicines, regardless of their income.

Under the Budget measure, in future, such persons would have had their full medical card downgraded to a GP visit card.

The Department of Health refused to comment on what the legal difficulties were that had delayed the measure, and whether the planned medical card cuts would go ahead. A spokesman said the plan was still being examined.

The new back-to-work medical card downgrading would have affected 22,000 people and was to have been implemented on a phased basis this year.

The measure was not intended to be retrospective, in that the HSE would not have sought a refund of costs of providing full medical card services to people who had been unemployed and had got jobs but who retained full cards under the rules that existed prior to the introduction of the new restrictions.

However, the Department of Health said late last year when the Budget measures were announced that people who already had medical cards under the old return-to-work rules would be assessed when the new scheme came in to see if their income qualified them for a full card or a GP card.

Medical card Budget measures also included downgrading some over 70s from full cards to GP visit cards, and continuing medical card 'probity' measures, which have included the controversial removal or downgrading of cards of people with serious illnesses.

The return-to-work GP medical card cut is one of a number of Minister Reilly's 2014 cost-saving initiatives which the HSE has said that due to technical reasons, may not generate the level of income predicted, or have been long-fingered.

The HSE, in its latest performance report, also lists under this heading a planned nursing staff bank; the graduate nurse scheme and the new rules which allow public hospitals to charge private patients for care, even if they are in a public bed.

The health executive says these and other measures, including €108 million in pay savings under Haddington Road, comprise a total of €266 million in savings measures that are not fully within in its control, which could add to the health service budget deficit at the end of the year if they do not succeed.

Meanwhile, proposals aimed at addressing the loss of thousands of discretionary medical cards by people with disabilities and serious illnesses will be brought before the Cabinet sub-committee on health today, according to a report in the Irish Independent.