Daily Archives: October 20, 2013

News Ireland daily BLOG by Donie

Saturday/Sunday 19th/20th October 2013 

Ireland’s GP Doctors claim treatment fees for dead medical card-holders


As Reilly told to save €113m, HSE bids to reclaim €1.5m from Irish doctors

Family doctors have claimed more than €1.5m of taxpayers’ money for treating medical card-holders who are dead or that don’t exist…….

As concerns grow that 100,000 people could lose their medical cards to meet €113m in savings announced in Budget 2014, some doctors have been creaming tens of thousands from the service both in over-payments from the State and in allowances.

It has emerged that some GPs continued to claim annual fees and payments for former patients who were either dead or had emigrated. Others charged the State overtime for seeing patients just minutes after 5pm. In one case highlighted last week by the Minister for Health, Dr James Reilly, a GP submitted a bill for €180,000 for “out of hours” allowances.

The €1.5m in over-payments was identified by the Health Service Executive (HSE) last year but not a cent has yet been repaid, despite its financial woes. 

According to informed sources, the HSE will go to the High Court if necessary to recover the money. A deadline of October 31 was set for doctors who received the overpayments, following protracted talks with their professional body, the Irish Medical Organisation (IMO).

The overpayments to doctors is just a fraction of the €113m the Government wants to taken out of the medical card scheme. But both Dr Reilly and the Minister for Finance Michael Noonan latched on to the overpayments when justifying the €113m savings target last week. One source said the figure would cover the average cost of a medical card for 1,500 people.

The overpayments were identified by the Comptroller and Auditor General in his report this year, but Fianna Fail’s Sean Fleming has claimed the HSE could be “squandering” as much as €5m a year on dormant cards.

The overpayments to GPs takes on a particular significance in light of the €113m the Government hopes to save from a “probity” review of medical cards, which is proving to be one of the most contentious measures in Budget 2014.

Opposition parties and concern groups have claimed that about 100,000 people would lose their medical cards this year. A further 35,000 over-70s are also set to lose their cards due to a change in income thresholds announced in last Tuesday’s Budget.

Taoiseach Enda Kenny denied that the review of medical cards would turn into a “witch hunt”, while Dr Reilly and the HSE have been forced to dismiss fears that seriously ill people who received discretionary medical cards could now lose them because they are over the strict income limits.

The medical card review has also signalled a rift between Dr Reilly and his senior cabinet colleagues, with the Health Minister attempting to disown the €113m savings target. In post-Budget briefings he said the figure was “given” to him by the Taoiseach and the Minister for Public Expenditure and Reform Brendan Howlin.

While sources close to Dr Reilly said the savings figure was foisted on him, others said it was imposed on Dr Reilly in frustration at his progress in identifying more savings in a department already cut to the bone.

Although the review of medical card eligibility was announced as a Budget measure, it has in fact been under way since earlier this year. The HSE embarked on a programme to weed out dormant medical cards after the system was centralised to one national office in 2011.

The Department of Public Expenditure and Reform latched on to the potential savings of between €65m and €210m highlighted in a HSE-commissioned PricewaterhouseCoopers (PwC) report on dormant medical cards.

The HSE warned that the PwC figures should be treated with “extreme caution”. But officials in Public Expenditure relied on them to come up with a target of €113m, which was then “foisted” on Dr Reilly and the HSE.

The Minister for Health said last week he was “concerned” about achieving the savings while the HSE is getting the figures independently validated.

The biggest concerns are centering on discretionary medical cards, which are given to patients who fail the means test but are considered hardship or special cases. Almost 43 per cent of the population holds a medical card or a GP visit card, with each card estimated to cost the State €1,000 a year.

Sources said that politicians lobbying local health managers on behalf of constituents caused to a surge in discretionary medical cards being issued across the country, until the system was centralised in Finglas in 2011.

Politicians, parents and patients groups have reported an anecdotal rise in people losing their discretionary medical cards as part of a review of eligibility that has been ongoing since earlier this year.

The HSE has denied this. According to the latest figures obtained from the HSE on Friday, 23,000 discretionary medical cards were issued since the start of this year and around 10,000 discretionary medical cards were withdrawn. Of those, 4,500 cards were withdrawn because the holders exceeded the income guidelines – almost half of them by 200 per cent.

Another 4,500 were withdrawn because the holders didn’t respond to queries. Around 800 had died.

The PwC report said there was an urgent need to “enforce” the removal of medical cards if people didn’t respond to HSE queries about their eligibility: “Estimates of excess payments under the scheme could be in the range of approximately €65m to €210m per annum. Significant savings in annual expenditure could therefore arise as a result of the identification and removal of these ineligible card holders.”

Fáilte Ireland says tourism survey reveals an upwards & positive result


Tourism tide ‘on the turn upwards’ says Fáilte Ireland after a positive  results survey show business up.

Irish Budget tried to cover up actual proposals says Michael Martin


Fianna Fáil criticises health cuts at Wolfe Tone commemoration

Fianna Fáil leader Michael Martin has said the budget was ‘cynical’.

Fianna Fáil leader Michael Martin has said the budget was “cynical” and “presented so as to try and cover up what was actually being proposed”.

Mr Martin was addressing annual Wolfe Tone commemoration at Bodenstown, Co Kildare today.

He said the cuts and “ill-thought out” policies of minister for Health James Reilly would do “immense damage” to the health system,

His party would fight against any effort to push through “flawed and dangerous health estimates,” Mr Martin said.While ministers said the free GP care for under 5s was the “start of universal access to primary care” but when the detail came out “ it revealed the largest ever cut in primary care funding in our history”, he said.He also criticised budget proposals impacting on older people. Mr Martin said the Government has begun an “ assault on the social contract between Irish society and its older people”

“It proposed mean-spirited and callous changes which made only a small impact on the wider budget but will have a major impact on older people,” he said.

New bill to abolish 80 of Ireland’s town councils now published


The number of Ireland’s councillor’s is to fall by almost 700 as town councils are abolished

Minister for the Environment Phil Hogan said the Local Government Bill would devolve power to local and regional level.

Legislation that will result in the biggest change in local government structures has been published by Minister for the Environment Phil Hogan.

The Local Government Bill proposes to almost halve the number of councillors in the country and will scrap all 80 town councils.

The abolition of town councils, which have been in existence for 115 years, accounts for the massive reduction in councillors – down from 1,627 to 949. In addition, the two councils in counties Tipperary, Waterford and Limerickare each being merged into one.

While the Government has argued that the Bill is a radical reform, the scrapping of town councils has been roundly criticised by all Opposition parties and by town councillors, whose positions will cease to exist after next year’s local elections. The councils will be replaced by 137 municipal district councils comprising county councillors from their respective electoral areas.

Legal challenge
The body representing town councils said the Bill woulddestroy local democracy and indicated it might take a legal challenge. The Association of Municipal Authorities ofIreland said the power town councils had to raise revenue through rates and other means would be lost. Its president,Cllr Willie Callaghan, said the removal of autonomy from town councils would destroy local democracy.

“It is very disappointing. You are destroying town councils,” he said to Mr Hogan at the event to publish the Bill yesterday.

The Bill provides for the abolition of the 80 town councils, which will be replaced by new entities, municipal district councils. These will be much larger entities, encompassing both urban and rural areas. Town councils will lose their independent financial revenue-raising powers. Instead, dictrict councils will be handed down annual financial allocations, irrespective of the amounts of money raised in each dictrict.

Mr Hogan said the changes would devolve power to local and regional level. He said a major component of this will be the revenue raised from the property tax, 80 per cent of which will be ringfenced for local authorities; and, from 2015, councillors will have the power to vary the revenue to suit local needs.

Fianna Fáil environment spokesman Barry Cowen said the Bill continued the Coalition’s policy of moving power into the hands of the elite. He said the municipal districts were “window-dressing”.

Sinn Féin said it opposed the reduction in the number of councillors to 949, saying it had proposed there should have been at least 1,165.

ISEQ climbs to five-year high amid a global pick-up


Irish stocks rose to their highest level in five years yesterday as the markets continued a winning streak that began early last week.

European stocks rose for a seventh day, their longest winning streak this year, as China‘s economic growth accelerated for the first time in three quarters.

The benchmark ISEQ Overall index climbed 0.9pc to close at 4,392.4 points while the Stoxx Europe 600 Index advanced 0.8pc to 318.47, extending its highest level since June 2008.

The gauge rallied 2.2pc this week as US lawmakers agreed to extend the government’s borrowing authority until early 2014 and end a partial government shutdown.

“We’ve seen activity in China picking up over the past few months, and the GDP figure is in line with that,” Richard Scrope, a fund manager at Oriel Asset Management in London.

“European earnings have been very mixed so far. Earnings expectations need to be supported by actual company results. Otherwise some valuations will start to look extended.”

SUSTAINABLE: The rebound was seen everywhere with national benchmark indexes advancing in all of the 18 western European markets. The UK’s FTSE 100 rallied 0.7pc, while France’s CAC 40 climbed 1.1pc. Germany’s DAX added 0.6pc.

“The global outlook is the strongest it has been in five years, and now looks more sustainable,” said Dublin-based Investec economist Phillip O’Sullivan.

The international backdrop is stronger and the news that Ireland will leave the bailout in less than two months has brought investors to Ireland who are looking to benefit as the economy recovers, he said.

Mortgage holders are also now on track for a long period of record-low interest rates after one of the most conservative central bankers in Europe said there was no need for a change.

Austrian’s central bank governor Ewald Nowotny said the ECB does not need to raise interest rates.

Mr Nowotny, who is a member of the governing council of the ECB, said a unilateral decision by the ECB to raise rates could create deflationary pressures in the eurozone.

Economists said his comments meant it would be well into 2015 before eurozone interest rates rise.

ECB president Mario Draghi promised to keep interest rates low or lower for an extended period to help put the eurozone economy back on a growth path.

Consumer price inflation in the eurozone slowed to 1.1pc in September.

The ECB main objective is to keep inflation below 2pc, though it looks at prices over the medium term.

That will help businesses and the 375,000 homeowners who have tracker mortgages.

Rates have come down from a high of 4.25pc to 0.5pc now. This has led to overall savings of close to €6,000 since the downturn for tracker holders, calculations by Karl Deeter of Irish Mortgage Brokers indicate.

Economist with KBC Bank Austin Hughes said he did not expect ECB rates to rise until the first three months of 2015.

Cognitive behavioral therapy more effective at reducing health anxiety


New research suggests that cognitive behavioral therapy is more effective at reducing health anxiety in medical patients, compared with standard care. This is according to a study published in The Lancet.

Researchers from the UK, led by Professor Peter Tyrer from Imperial College London, say an additional benefit of cognitive behavioral therapy (CBT) is that it can be delivered to patients by non-specialist staff with minimal training at minimal cost.

According to the UK’s National Health Service (NHS), health anxiety, orhypochondria, is defined as obsessive worrying about health, “usually to the point where it causes great distress and affects your ability to function properly.”

Health anxiety, can cause some people to experience unexplained physical symptoms, such as headaches or chest pains, leading to a person assuming they are suffering from a serious disorder, regardless of a clinician’s reassurance that they are healthy.

Researchers say that 10-20% of patients experience health anxiety, but CBT therapy has been shown to help.

According to the researchers, 10-20% of hospital patients suffer from health anxiety, and this poses a substantial burden on health services since a patient’s fear of having a serious disorder leads to medical consultation.

The study authors note that previous studies have demonstrated that CBT – a therapy that aims to change a person’s behavior and thought patterns – is successful as a treatment for other anxiety disorders. Therefore, the researchers set out to determine whether this therapy would be effective in treating health anxiety.

A 1.8 million year-old skull gives new insight into human evolution


A stunningly well-preserved skull from 1.8 million years ago offers new evidence that early man was a single species with a vast array of different looks, researchers said.

With a tiny brain about a third the size of a modern human’s, protruding brows and jutting jaws like an ape, the skull was found in the remains of a medieval hilltop city in Dmanisi, Georgia, said the study in the journal Science.

It is one of five early human skulls — four of which have jaws — found so far at the site, about 100km from the capital Tbilisi, along with stone tools that hint at butchery and the bones of big, sabre-toothed cats.

Lead researcher David Lordkipanidze, director of the Georgian National Museum, described the group as “the richest and most complete collection of indisputable early Homo remains from any one site”.

The skulls vary so much in appearance that under other circumstances, they might have been considered different species, said co-author Christoph Zollikofer of the University of Zurich.

“Yet we know that these individuals came from the same location and the same geological time, so they could, in principle, represent a single population of a single species,” he said.

The researchers compared the variation in characteristics of the skulls and found that while their jaw, brow and skull shapes were distinct, their traits were all within the range of what could be expected among members of the same species.

“The five Dmanisi individuals are conspicuously different from each other, but not more different than any five modern human individuals, or five chimpanzee individuals, from a given population,” said Zollikofer.

“We conclude that diversity within a species is the rule rather than the exception.”

Under that hypothesis, the different lineages some experts have described in Africa — such as Homo habilis and Homo rudolfensis — were all just ancient people of the species Homo erectus who looked different from each other.

It also suggests that early members of the modern man’s genus Homo, first found in Africa, soon expanded into Asia despite their small brain size.

“We are thrilled about the conclusion they came to. It backs up what we found as well,” said Milford Wolpoff, a paleoanthropologist at the University of Michigan.

Wolpoff and Adam Van Arsdale of Wellesley College published a study in the journal Evolution last year that also measured statistical variation in characteristics of early skull fossils in Georgia and east Africa, suggesting a single species and an active process of inter-breeding.

“Everyone knows today you could find your mate from a different continent and it is normal for people to marry outside their local group, outside their religion, outside their culture,” Wolpoff said.

“What this really helps show is that this has been the human pattern for most of our history, at least outside of Africa,” he added.

“We don’t have races. We don’t have different subspecies. But it is normal for humans to vary, and they have varied in the past.”

But not all experts agree.

“The conclusions that they draw are misguided,” said Bernard Wood, director of the hominid paleobiology doctoral program at George Washington University.

“What they have is a creature that we have not seen evidence of before,” he said, noting its small head but human-sized body.

“It could be something new and I don’t understand why they are reluctant to think it might be.”

In fact, the researchers did give it a new name, Homo erectus ergaster georgicus, in a nod to the skull as an early but novel form of Homo erectus found in Georgia.

The name also retracts the unique species status of Homo georgicus given to the jaw that was found in 2000 along with other small, primitive skulls.

The jaw lay a few yards from where Skull 5, belonging to the same owner, was later discovered in 2005.

Co-author Marcia Ponce de Leon of the University of Zurich said Skull 5 was “perfectly preserved” and “the most complete skull of an adult fossil Homo individual found to date”.