Sir, – The report "HSE recoups €3 million for care of deceased medical card-holders" on the recouping of €5 million – €3 million recouped to date, and a further €2 million to come – from GPs who were paid for deceased medical card patients between 2008 and 2013, without explaining the full context, is a missed opportunity to correct a popular misconception about general practice funding.
This sum is tiny considering that the 2012 Price Waterhouse Cooper report on medical cards referred to an over-payment to general practice of between €65 million and €210 million in 2011 alone for deceased patients and patients who had medical cards but possibly were not entitled to them.
It also pales into insignificance compared to the recent under-payments to general practice.
Some patients are having valid medical cards cancelled because their GP is not writing any prescriptions for them and therefore they are considered as not using the service.
Others are not responding to “probity checks” because they have moved house or are just incapable of dealing with the administration. Some patients are clearly entitled to a medical card but cannot get one for some bureaucratic reason.
In each of these cases often the GP still provides a service but loses out financially. Also many GPs find that they are providing services that entitles them to an extra payment and for which they historically received extra payments as per their contract, but the HSE just refuses to pay often with no explanation.
GPs are now also providing many services that were considered hospital activities in 1989, the time of our last contract negotiations, so payment for them is not even considered.
The recovery of an overpayment of €5 million spread over many years to GPs is great publicity for the HSE.
This is particularly so when there is no balancing comment on how it has utilising sharp practices to underpay GPs a similar sum each and every month over the last two or three years and also the previous highly publicised, greatly exaggerated overpayment. – Yours, etc, Dr WILLIAM BEHAN Walkinstown, Dublin 12.