Finian McGrath
Question:336 Mr. F. McGrath asked the Minister for Health and Children if his Department overpaid doctors in the region of ?18 million for treating up to 20,000 dead or ineligible patients. [22197/02]
Written Answers. - General Medical Services Scheme.
The Government decision to extend automatic medical card eligibility to all persons aged 70 years and over with effect from 1 July 2001 was announced on budget day in December 2000. Original estimates of the numbers, 39,000 persons, likely to benefit from this initiative were based on the Central Statistics Office estimate of persons in this age category less the number of those already registered as medical card holders.
It subsequently came to light that the health boards and general medical service databases of medical card holders in the over-70s age category were inaccurate. My Department instructed all health boards to carry out a review of their over-70s medical card lists. This exercise has resulted in excess of 15,200 duplicate entries and entries for deceased persons being removed from those lists. My Department has further requested the chief executive officers of the health boards to arrange for an immediate full review of the entire GMS list for their functional areas to be com pleted by the end of the year. It is likely that this comprehensive review will result in further entries being removed from the lists.
The GMS payments board estimates that the overpayments made to doctors in respect of persons aged 70 and over are at least €12 million. However, the full extent of the overpayments in respect of all age categories will not be determined until the comprehensive review under way has been completed. When the full extent of the overpayments is known, arrangements will be made for the recovery of these from the doctors concerned. It is intended to adopt a national approach and that there will be discussions with the Irish Medical Organisation with a view to agreeing a methodology for the recovery of the overpayments.
Michael Ring
Question:337 Mr. Ring asked the Minister for Health and Children if he will, as part of the GMS contract with doctors, ensure that the relevant health board or authority is notified by the doctor when a patient dies; when the contract will be negotiated again; if it is negotiated every year; and if this clause can be made part of the contract. [22287/02]
The current GMS contact dates from 1989. Clause 11 of the contract states, "The medical practitioner shall co-operate, where possible, in advising the health board of known alterations to his list of patients". Amendments to the contract since then reflect the agreed outcome of industrial relations negotiations between the Department and the Irish Medical Organisation, the licensed negotiating body for general practitioners. The contract is not negotiated annually and no clause may be inserted into it unless it arises in the context of an agreement between the two parties.
The implementation of the Government decision to extend automatic medical card eligibility to all persons aged 70 and over has brought to light inaccuracies in the health boards and GMS payments board databases. My Department has, therefore, instructed health boards to put in place an effective proactive management system for systematically reviewing eligibility and track ing the movement of medical card holders into the future.