HSE raised concerns over accuracy of PwC report on medical card cuts

The HSE raised concerns 18 months ago over the accuracy of the PwC medical card report which is at the centre of controversial claims that €113m can be cut from the system.

In response to an Irish Examiner query in Apr 2012, a spokesperson said the “€65m-€210m” estimated savings PwC put forward were a rough estimate only.

The spokesperson said that, due to the small number of cases reviewed and the lack of a database audit, the 52-page report’s suggestion such a large amount of money could be saved is not entirely accurate.

And she noted a disclaimer from the company, saying the projected figures were “indicative only and cannot be relied on for any purpose other than providing a broad understanding” of the issue.

The call for caution was backed up by a Comptroller and Auditor General report last month.

The revelation comes a day after HSE director general Tony O’Brien told the Oireachtas Health Committee cuts in other service areas are unavoidable if the €113m medical card review savings target is not met.

And with the health budget only being finalised after last-ditch talks between Health Minister James Reilly and Public Expenditure and Reform Minister Brendan Howlin at the weekend, the questioning of the report at the centre of the cuts will put further focus on how the figure was decided.

In the Apr 2012 response to the PwC report, a HSE spokesperson said: “In Feb 2012, the HSE initiated a review of the centralised processing of medical cards. PwC assisted with the review to examine the service issues and they conducted a high level assessment of potential excess expenditure.

“Given the short time in which this part of the work was conducted it cannot be relied on for any purpose other than providing a broad understanding of the potential scale of the problem.

“A more detailed analysis, taking a considerably longer period of time and involving detailed reviews of the records on the database would be required in order to obtain a more reliable estimate.”

The more detailed review is understood to have been conducted by private consultancy firm Accenture last year.

Last month, the C&AG raised similar concerns over using the analysis to impose significant service changes.

The watchdog said the PwC document did not base its views on an “analysis of database and expenditure”. It said the Accenture report “did not develop a baseline estimate of the level of excess expenditure under the medical card scheme”.