The chairman of the Dáil Public Accounts Committee has called on the heads of the Health Service Executive and the Department of Health to resign.

Fianna Fáil TD John McGuinness said HSE secretary general Tony O’Brien and Department secretary general Ambrose McLoughlin had failed the public and the system was not fit for purpose. “This is groundhog day. We’re dealing with the same issues all the time,” he said.

Dr McLoughlin had earlier told the committee the HSE was heading for an end-of-year deficit of €500 million, though Mr O’Brien said this estimate assumed nothing would change by way of efforts to reduce the deficit.

Mr McGuinness accused the two men of presiding over a lack of efficiency, poor spending controls, poor value for money and a failure to achieve stated goals. He said half the population were “frightened out of their lives” because of the medical card review process. Cardholders were unable to cope with medical costs and a system that was failing them.

He said the public were “utterly disgusted” at the handling of the medical card review process, with people being told in the middle of pharmacies that their card had been “pulled”.

Reviewing the performance of the health service in various areas, Mr McGuinness said that the HSE was a business and if he were a shareholder he’d say it was not fit for purpose.

Dr McLoughlin said Ireland had been though an extraordinary international crisis and health spending had fallen more than anywhere outside Greece. Costs had been reduced and productivity increased but the service was now having to provide “less with less”.