The head of the Health Service Executive’s primary care reimbursement team, Patrick Burke, said most of the problems being experienced by the public were the result of action taken by IMPACT members since January 2009.

"Efforts to establish local communication facilities for the public are being explicitly blocked by IMPACT and this is adding to the discomfort that clients are feeling," he said.

Committee chairman, Sean O Fearghail, said committee members were unhappy regarding the centralisation of medical cards for over 70s in Dublin.

"There have been cases of people in severe need facing long delays to get their cards, documentation getting lost and there have been constant difficulties in contacting the office," he said.

Mr Burke said industrial relations difficulties worsened in September when staff in local offices across the country directed the public to contact the central office, now receiving around 5,000 calls a day. He said the new centralised service would reduce the cost of the medical card scheme by more than €10m a year and result in applications for medical cards being processed in 15 days.