Medical scheme paid 200 GPs €240,000 each in 2002

Nearly 200 GPs earned more than €240,000 each last year in the Government-funded medical payments scheme. The figure is nearly four times as many as in 2001.

The doctors received the money as part of the General Medical Services (GMS) scheme which provides free GP services and drugs to a third of the population. More than 5,000 doctors, dentists and pharmacists are provide services under the scheme.

In its annual report published today the GMS scheme also said there were 353 GPs earning between €180,000 and €240,000 last year. The average payment to doctors per eligible patient was €221, up from €169 in 2001.

Among the top earning pharmacists 254 earned more than €120,000 last year, 97 more than in 2001. Fifty six dentists earned over the same amount under the scheme.

The GMS also reported an increase in its running costs by nearly 24 per cent to €1.27 billion last year.

The report said a review had seen the number of people eligible fall by over 30,000 to 1.168 million last year. The inaccuracy of the medical card lists has been one of the main criticisms aimed at the scheme, which was recently identified as a "financial risk to the health service" in the Brennan report on the financial management of the health service.

The Brennan report said there was no evaluation of attendance patterns, prescribing patterns and hospital referrals.

Brennan also noted the cost of running the card scheme has increased two-and-a-half times since 1997, due in part to the extension of the medical card availability to all over-70s and inaccurate data on whether patients were eligible for a card.

The move by the GMS to review its medical card list was prompted by revelations that some GPs were paid for treating medical card patients who were dead or had moved to a different health board area. In its annual report today the GMS board said it intended to recoup this money as part of its contract talks with general practitioners.

Last year general practitioners were paid €282 million under the GMS, a 32 per cent rise on the previous year. Pharmacies received €817 million for services provided to holders of medical cards and participants in other community drug schemes, an increase of 21 per cent on the previous year.

An increasing and aging population was driving up the level of payments along with rising payments to medical professionals, the board said. The board submitted an estimate for €1.45 billion to the Department of Health for its services in 2003.

By the end of last year some 2.54 million people were eligible to benefit from a range of schemes under the GMS, including medical cards, the drugs treatment scheme, long term illness, dental treatment and ophthalmic services schemes.

The Brennan report recommended the introduction a single flat-fee for dispensation of all drugs under public funding schemes, a proposal opposed by pharmacists.

Under health reforms contained in the Brennan and Prospectus reports the GMS board will come under the auspices of the soon-to-be established Health Service Executive.

Mr Patrick Burke, chief officer of the GMS Board, said more than 43 million prescriptions were processed last year, a rise of four million. He said the GMS was working to resolve claims that contained illegible or incomplete data and said talks were ongoing with pharmacists to resolve the issue.