A file of a randomly selected patient during an audit of Mater Dei Hospital remained “untraced”, a report by the National Audit Office (NAO) has warned.

The case of the missing file was highlighted during a follow-up audit into the efficiency of Mater Dei’s billing of foreign patients.

An audit by the NAO published in 2017 had found that the amount of long-term overdue fees owed by foreign patients was increasing at an “alarming rate”.

In a follow-up report published last month, the NAO said the situation had worsened since then, with debtors owing Mater Dei €9.4 million by the end of December 2021.

The NAO “satisfactorily noted” that Mater Dei was issuing invoices to foreign patients upon discharge, with bank deposits in connection with foreign patient treatment amounting to €1.2 million, a 129 per cent increase since the 2017 audit.

However, the audit noted how Mater Dei did not provide any plan of action how it intended to recover debts when a patient’s permanent address is unavailable.

The NAO also said it was not provided with evidence of any monitoring to confirm that all services rendered by Mater Dei to foreign patients were invoiced and duly paid.

During the course of the follow-up audit, the NAO also flagged how “the file of one of the randomly selected patients could not be reviewed as it remained untraced by the end of the audit.”

55 per cent of POYC recommendations implemented

In a separate follow-up audit found in the same report, the auditor general noted how only 55 per cent of the NAO’s recommendations to improve controls in the pharmacy of your choice (POYC) scheme had been fully or even partially implemented.

While acknowledging the impact of COVID-19, the NAO encouraged the scheme’s administrators to turn their attention to issues that were not fully addressed, particularly those related to the IT system and stock control.

The report says that the majority of pharmacies still did not carry out stocktakes.

This, the report continues, was mainly due to the fact that in June 2020, a joint directive was issued by the Chamber of Pharmacists and the Chamber of Small and Medium Enterprises,  directing pharmacies and pharmacists not to carry out such stocktakes.

It was noted how no timeframe was set on the directive, as the issues behind it were still being negotiated with the health minister.