Doctors' claims at Central Mental Hospital audited
HSE audit report claims payments were made for more hours than doctors were in building
A HSE audit also found evidence of overclaiming for mileage at the Central Mental Hospital. File photograph: Dara Mac Donaill.
Two GPs claimed €71.25 per hour for three hours attending patients at the Central Mental Hospital in Dublin on 11 occasions where a visitor log showed they had only spent between one and two hours at the hospital. *
An internal HSE audit of the hospital also revealed irregularities with some payments to consultants, including payments for “second opinions”, grant payments for continuing medical education, and travel.
The audit report dated September 29th 2017 notes that two GPs attached to the same family practice attended the hospital on two weekdays to provide care and assistance to patients.
The Tuesday clinic was for two hours and the Wednesday one lasted for three hours, with €71.75 claimed for each hour worked. A review of 111 clinics claimed from July 2014 to August 2016 highlighted 11 instances where the three-hour clinic lasted only between an hour and five minutes and two hours.
Four hours work was claimed for two clinics held on separate dates in May 2016 when the gate book did not record either GP entering or leaving the hospital on those days.
The auditors said the possible implications were that “either hours were claimed erroneously or gate book records were not maintained properly”.
They said management should identify if hours were claimed for unperformed clinics and seek to recoup the costs where overpayments had taken place.
The auditors also said the GP claim form should include the time of each clinic performed and that management should ensure that the GP who actually attends the hospital was recorded in the gate book.
In another highlighted case, a consultant was paid €2,483.52 for five visits where he gave “second opinions” in relation to a patient’s treatment. However, the records showed that four of these opinions were carried out during a single two-hour visit to the hospital in August 2016.
The audit also noted that one consultant included a “Leisure Plus” option when buying airline tickets using a grant towards their continuing medical education (CME), entitling them to fast-track and priority boarding. The auditors said consultants should be reminded that this was not permitted as it was not providing value for money, which was a key principle underlying this grant funding.
On two separate occasions, two consultants travelling using the continuing medical education grant claimed the full cost of their hotel bill when two guests shared each room. One hotel cost €495 and the other cost €1,645.
The auditors said the possible implications were that part of the grant intended for use by consultants “may have been used for other people”. They said management should identify if costs were paid for friends or relatives and that these should be recouped.
The audit report recommends that management should ensure that consultants claim the CME expense promptly and that they do not exceed the €3,000 per annum allowance.
The audit also found one consultant claimed 200km mileage for each journey from the Dundrum-based hospital to Portlaoise Prison. The distance from the consultant’s home to the prison was 138km, a difference of 62km.
In December 2016, the consultant claimed for nine return journeys totalling 1,800km even though the total distance from their home to Portlaoise Prison was 1,242km, resulting in an overpayment of €340.
The auditors said that not claiming from the “shortest practicable route, i.e. the home address”leads to financial loss for the HSE.
One consultant claimed 191km (€116) for two return journeys from the CMH to Portlaoise Prison on days where their leave card indicated they were on a day’s annual leave, and a half-day’s annual leave respectively.
A consultant also claimed for an hour’s travelling time when he was already on site working, the report said.
Other findings included healthcare assistants overclaiming for mileage, where they claimed the distance from the hospital to Lucan rather than from their homes.
The auditors also noted that one staff member was responsible for all administrative duties relating to the patient private property account at the Central Mental Hospital, which held a balance of over €1.3 million in 138 current accounts.
They said that having one officer performing all the tasks related to this account was “contrary to the financial regulations and increases the risk of fraud”.
* The HSE has confirmed, since publication of the audit report, that no overpayments were claimed by the GPs referred to in the report.
* This article was edited on November 22nd, 2018