Doctors get ‘ghost payments’ for patients who are long dead

Date Published: 20-May-2010

By Darragh McDonagh

The Health Service Executive (HSE) has paid more than €5 million in capitation payments to general practitioners since January 2009 in respect of medical card holders who were deceased.

Since the administration of the medical card scheme for people over 70 was centralised to the Primary Care Reimbursement Service (PCRS) last year, around 20,000 cardholders have been removed after it was discovered that they were deceased.

The HSE had continued to make capitation payments to GPs in respect of these cardholders after their deaths. The value of these “ghost payments” since January 2009 is understood to have amounted to €5m.

The issue is to be raised at a meeting of the HSE Regional Health Forum West in Galway next week in the form of a question from its chairperson, Cllr Padraig Conneely.

The discovery of the “inappropriate payments” has been represented as a saving by the HSE as the removal of the deceased cardholders will reduce the amount payable to GPs under the scheme in future.

However, the Irish Medical Organisation (IMO) has said that any effort to recoup monies erroneously paid to GPs would be resisted unless similar anomalies which have resulted in underpayments to doctors were addressed on a “quid pro quo” basis.

“We recognise that there are anomalies but the medical card system is the responsibility of the HSE to administer and it is an imperfect system,” said Dr Ronan Boland of the IMO.

“We have highlighted anomalies in other areas that have resulted in underpayments to GPs and I think it would be unjust for the HSE to recoup the money if arrears that are owed to GPs due to administrative failings are not also addressed.”

Chairman of the HSE Regional Health Forum West Cllr Padraig Conneely described the revelation as a “shocking indictment” of the administrative system within the HSE.

“At a time when frontline services are suffering from cutbacks and cash shortages at the two Galway hospitals, the HSE has been paying out millions of euro in respect of people who clearly no longer require medical care,” he said.

For more on this story, see the Galway City Tribune