C&AG criticises inaccurate over-70s medical card estimate

The Comptroller and Auditor General has criticised the Department of Health¿s failure to accurately estimate the full cost of extending the medical card to all persons over 70.

In his annual report for 2001, the C&AG said an original cost estimate for the scheme of €19 million was based on out-of-date figures for the number of over 70s. By April of 2002 it was estimated that the cost would be in the region of €51 million with 30,000 more applicants to the scheme than originally forecast.

These inaccuracies led to the overpayment of doctors and pharmacists by nearly €12 million annually.

The €19 million estimation was based on a deal negotiated in June 2001 between the Department of Health and the Irish Medical Organisation agreeing a fee of €438 per annum for newly eligible over 70s to the medical card scheme.

Negotiations with the Irish Pharmaceutical Union are ongoing and it is estimated that the eventual deal will cost approximately €24 million, the report said.

The inaccuracies were caused by duplicate entries into Health Board and General Medical Card (payments) (GMS) lists and the non-removal of persons who had died or moved.

Initial estimates for the coast of introducing the over 70s medical card scheme were based on 39,000 eligible persons but by April 2002 the number of new applicants was expected to exceed 70,000.

As a result of a cleansing exercise some 14,100 "excess" medical cards had been identified and were being removed from the system, the report notes.

If the examples of the over 70s was followed, the report said it would be reasonable to expect inaccuracies among the 327,251 medical cards in February 2002 registered under the GMS scheme.

The C&AG said a cleansing programme for the GMS database was planned.

It also noted that the cost of providing medical cards to all over 70s was increased because the Government announced the measure in Budget 2000 prior to any agreement with the IMO or the IPU. Announcing the measure before concluding negotiations strengthen the unions' position, the C&AG said.