Eastern region doctors paid for treating 12,419 ‘ghost patients’

DOCTORS in the eastern region were paid for treating 12,419 dead patients because health boards failed to remove names of the deceased from medical card holder lists.

Figures obtained yesterday from the General Medical Services Payments Board show the highest number of overpayments occurred within Eastern Regional Health Authority (ERHA), followed by the Southern Health Board, where doctors were paid for treating 3,446 ‘ghost patients’ between February 2002 and June 2003.

In the Western Health Board, doctors were paid for treating 2,641 ‘ghost patients’ during the same period.

Figures previously released under the Freedom of Information Act show the scale of overpayments was greatest in the ERHA, where doctors were overpaid an average of €3,651 each. Nationally, 2,000 GPs, on average, received excess payments of €2,296.

A statement from the GMS Payments Board yesterday set total overpayments between February 2002 and June 2003, at €8.294 million (€7.54 million in relation to capitation payments and 0.754 million in respect of superannuation).

Capitation payments are the flat fee paid by the Government to GPs for treating medical card holders. The superannuation fee goes towards the GP’s pension and represents a 10% top-up fee on the flat fee.

Overpayments were made in respect of 28,156 ’ghost patients’, as revealed to the Public Accounts Committee in September.

Yesterday, the GMS Payments Board said the degree of overpayment per individual record “would depend on the length of time between identification and removal, and the date when eligibility was determined to have ceased”.

Figures previously released under the Freedom of Information Act show that while most doctors received excess payments for less than a year, GPs were overpaid for 13,250 patients for up to five years and received money for 1,230 patients for between five and 14 years or more.

The Department of Health is seeking to recoup these monies, but GPs are resisting, arguing that they did not make any claims for payments in respect of these ‘ghost patients’. They say the maintenance of accurate lists is the sole responsibility of the health boards.

The Irish Medical Organisation (IMO) has said that, unless the health boards can prove they overpaid GPs, the money will not be refunded.

A spokesperson for the Department of Health confirmed yesterday that secretary general Michael Kelly is still awaiting legal advice on the GPs’ refusal to cough up.

IMO GP committee chairman Dr James Reilly said doctors did not believe they owed any money under the GMS and that, unless an independent review body could prove otherwise, none of the money the State claimed was made in respect of ‘ghost patients’ would be given back.

The IMO wrote to Mr Kelly yesterday again outlining its position and demanding that all payments made in respect of medical card holders reflect absolute transparency.

He said health boards were guilty of a multitude of inefficiencies in making justified payments to GPs and that, until these inefficiencies were ironed out, there would be no question of any refunds because of errors in ‘ghost’ payments.