Around 1,780 GPs were overpaid amounts from €31 to €42,000 in respect of almost 30,000 former patients in the over 70s age bracket.
Attempts to have the money repaid to the taxpayer are tied up in an industrial relations dispute and also hampered by the threat of legal action on other doctors’ grievances.
A total of 104,236 patients’ names were removed from the medical card scheme after the Controller and Auditor General (C&AG) said the list should be updated three years ago.
The C&AG’s warning followed the Government’s decision at that time to extend the medical card to everyone over the age of 70 regardless of their financial status.
Most of the removals in the three years since were “normal deletions” arising after a patient died, moved from one health board area to another or became ineligible for free health services.
However, almost a third of the removals, a total of 29,165, were over 70s who had died.
The C&AG estimated the sum paid to doctors for caring for these ghost patients was €8.468 million.
The C&AG noted that the Department of Health told the GPs’ representative body, the Irish Medical Organisation (IMO), in September last year that repayment would be demanded of all the doctors concerned.
But the IMO refused to ask its members to cough up, claiming that they had been underpaid for other categories of patients such as newborn babies and teenagers who were eligible for a medical card in their own right at the age of 16.
The department feared legal action on the alleged underpayments and agreed to examine the claims in an exercise due to be completed by the end of this month. In relation to the overpayments, however, the C&AG said: “Nothing had been recovered by July 2004.”
The C&AG also noted that there had been no amendments to the GPs’ contract to safeguard against future overpayments because the entire contract was facing revamp due to changes proposed by the Hanly Report on reform of the health services.
In another finding on the Department of Health, the C&AG said the total sum repaid to patients left short by changes in the Drugs Payment Scheme in 2001 had reached €6.438m by July 2004. Over 36,000 refund cheques were issued and the average amount paid back was €177.