Dispute over euro6m in medical card payments

GPs and the Department of Health have differed on the repayment of €6 million which was paid to GPs for treating medical card patients who were dead or had moved away.

Yesterday, a senior Department of Health official told the Dáil Public Accounts Committee he was "very confident" the department would be able to recoup the money from the GPs following talks with the Irish Medical Organisation (IMO).

However, last night the IMO said its legal advice supported the position of GPs. Doctors had constantly warned that the medical card lists were inaccurate, and if a review of the list maintenance system was carried out, GPs could actually be owed money, a spokeswoman said.

Asked if the GPs would refuse to repay the €6 million, she said "we'll have to wait and see".

The IMO honorary treasurer, Dr Martin Daly, said GPs had been calling for a fair and transparent system of list maintenance since 1989. GPs had sought a central computerised system to avoid inaccuracies on medical card listings.

Nearly 40,000 medical cards have been removed from the register following the discovery that GPs were being paid to treat patients who had died or moved away.

Officials from the 10 health boards came under pressure from Public Accounts Committee members yesterday to explain why they had not put more rigorous checks in place.

The comptroller and auditor general, Mr John Purcell, told the meeting that there were warning signs that GPs were being overpaid for medical card patients years earlier.

When laminated medical cards were being introduced in 1998, 30,000 medical card holders had to be removed from the database, he said. The health boards should have acted then to ensure that the problem did not occur. "But in the heel of the hunt, they weren't as diligent as they should have been."

The chairman of the Public Accounts Committee, Mr John Perry TD, said the controls in place were "a shambles".

There were "huge anomalies" in the system, and he asked how could the General Medical Service (Payments) board allow a system to operate which involved several different databases.

Mr Patrick Burke, chief executive of the GMS board, said the board had no executive authority over the databases or systems used by the health boards.

Mr Tom Mooney, deputy secretary of the Department of Health, said he was "very confident" that the money would be recouped from GPs.