Medical card ‘ghost patients’ rise to 40,000

THE number of medical cards held by people who have died or moved away from their health board area has risen to almost 40,000 — up from 25,000 in January.

Payments to doctors for treating these so-called ghost patients is now estimated at €6 million, down from the previous estimate of €12 million, the Public Accounts Committee (PAC) heard.

However, the health service was warned about the flaws in the medical card system five years ago when more than 30,000 ‘ghost’ patients were wiped off the list, the public finance watchdog was told yesterday.

The gross underestimation of the number of people over 70 entitled to a medical card brought the inaccuracies in the entire system to the fore.

The administration of the medical card system was described as a shambles by the PAC chairman John Perry.

In a scathing attack on the failures to learn the lessons of 1998, Comptroller and Auditor General John Purcell said the warning signs were there.

“At the heel of the hunt, the health boards weren’t as diligent as they should have been,” he said.

Health board chiefs said they were committed to getting the money back from doctors, but the Irish Medical Organisation has threatened to go on strike if they attempt to recoup the overpayment. The Department of Health has blamed health boards for failing properly to manage the database of medical card holders.

However, the health boards blame a letter issued by the Department in 1995 which told them to go easy on over 70s, by only reviewing such medical cards every five years.

“The sending of forms to the medical card holder should be avoided. These procedures are not intended to interfere with the arrangements already put in place by health boards to ensure that patients’ panels are accurate,” the letter said.

Despite the change in operations and subsequent problems that arose, Department of Health deputy secretary general Tom Mooney said it was still technically the official policy not to send forms to over 70s. However, that had now been overtaken by the current situation.

The matter would be discussed immediately with Health Minister Micheál Martin, he said.

Criticising health boards and the General Medical Services Board for their inaction on tightening up the system, Deputy Perry said they had a statutory duty to inform the Department of Health of the lack of the controls, yet had not done so.

GMS chief officer Patrick Burke said his organisation did not have executive authority over the system and differing systems were used by the health boards.

Fianna Fáil TD Batt O’Keeffe said that the situation was caused by extraordinarily bad management and a total lack of control.

“It is an extremely sad indictment of the management of health boards,” he said. “It shows a lack of control and management.”

The Irish Medical Organisation said last night that it had received legal advice supporting its position in relation to reported inaccurate health board patient listings.