Doctors treating 'ghost patients' for 14 years

Doctors have been receiving payments for deceased patients whose medical cards had not lapsed when they died and for invalid card holders for up to 14 years, it has emerged.

Overall, an estimated €6 million has been overpaid to GPs as a result of inaccurate records maintained by health boards relating to patients on the General Medical Services (GMS) scheme.

Figures obtained under the Freedom of Information Act show that almost 2,000 GPs, on average, received excess payments of €2,296.

The scale of overpayments was greatest in the Eastern Regional Health Authority, where doctors were overpaid an average of €3,651 each.

While most doctors received excess payments for less than a year, GPs were overpaid for 13,250 patients for up to five years and received money for 1,230 patients for between five and 14 years or more.

Problems with the inaccuracy of health boards' GMS records became apparent when the cost of a decision to provide a medical card to all over-70s spiralled beyond original projections.

It emerged that annual State payments were still being made to doctors for thousands of "ghost patients", who had either died, were duplicated on official lists or had moved to another area.

A root-and-branch "cleansing" of databases has since resulted in more than 63,000 patients being struck off the GMS list.

The Department of Health is now seeking to recoup the money from doctors, but has run into obstacles due to the stance of GPs' representatives.

The Irish Medical Organisation said it believes doctors have also been underpaid and wants a report completed into this before any money is recouped.

The IMO's honorary treasurer, Dr Martin Daly said: "If there was a thorough examination of underpayments and overpayments, there would be a net payment owed to doctors."

Dr Daly rejected suggestions that doctors failed to inform health boards about patient deaths and said the statutory responsibility for maintaining accurate records lies with the health boards. Annual payments for individual medical card patients range from €33 for infants to €500 for the over-70s under the new scheme.

Department of Health officials said last March they were "very confident" that the money would eventually be recouped from GPs, although it appears there has been little progress on the issue since the IMO made its position clear last March.

The chief executive of the GMS (Payments) board defended the board's actions and said it had no executive authority over the databases or systems used by the health boards.

When the issue was examined by the Public Accounts Committee earlier this year, the chairman, Fine Gael TD, Mr John Perry, said it was clear that record-keeping by health boards was in "a shambles". The Comptroller and Auditor General, Mr John Purcell, told the meeting there were warning signs that GPs were being overpaid for medical card patients five years ago when a plastic medical card was introduced in 1998.

However, he said health boards failed to act at the time to ensure all records were accurate.

Health boards, meanwhile, are due to establish a new system of maintaining a national medical card database early next year, instead of maintaining separate local databases. Officials say the electronic system will allow them to check for duplicate entries.