No overview of the overall costs in primary care

The accommodation, subsistence and medical care for aliens in need of help and protection are the key elements of primary care. Today, the Austrian Court of Audit (ACA) published its report on "Primary Care in Vienna". This audit was also carried out upon the suggestion of the Vienna City Councillor for Social Affairs. The audit spanned the years from 2014 through 2018. The implications of the COVID-19 pandemic were not taken into account.

The ACA notes that the Austrian entities responsible for primary care had no overview of the actual overall costs incurred in this regard. For the years from 2014 to 2018, the ACA’s auditors ascertained the overall costs as follows: the costs incurred by the Federal Government and the provinces, which were settled reciprocally, totalled some EUR 2,339 million in the audited period. The annual costs fluctuated between some EUR 200 million in 2014 and some EUR 746 million in 2016. These figures, however, did not depict the incurred overall costs since, for example, administrative costs or expenditure for services not provided for in the primary care agreement had not been included. The ACA recommends to the Federal Ministry of the Interior to ascertain, together with the provinces, the overall costs for primary care and to prepare corresponding annual reports.

Lacking transparency and plausibility

The number of persons in need of primary care increased continually from 2014 to 2017. In early 2017, for example, 20,438 persons received primary care in Vienna. In 2018, this number decreased to 19,233 and in 2019 the number of persons in need decreased by about a quarter compared to 2017 (15,318 persons). In the report, the auditors criticize that the Vienna Social Fund (Fonds Soziales Wien) did not have an overview of the services provided to individual persons and had no related data at its disposal. The necessary data comprise, for example, master data, control information by the Federal Ministry of the Interior and approved services that would be charged to the Federal Government. Sufficient transparency and plausibility were therefore lacking. The ACA recommends to the Vienna Social Fund to establish a central IT support unit that can provide at all times a complete and up-to-date overview of the relevant data and services for persons receiving primary care. 

Cooperation between the Federal Ministry of the Interior and the province of Vienna is to be improved

The assessment of the eligibility of persons receiving primary care requires a cooperation between the Federal Government and the provinces. The ACA sees potential for improvement as regards the communication and cooperation between the Federal Ministry of the Interior and the Vienna Social Fund to identify and manage the risks arising from the provision of services in the framework of primary care. In the audited period, the Federal Ministry of the Interior and the Vienna Social Fund performed – independently of each other – checks in varying degrees of intensity and with different objectives. Furthermore, their respective powers and competences to exercise control differed from each other. The ACA recommends to the Federal Ministry of the Interior and the Vienna Social Fund to carry out a joint risk assessment with regard to the execution of primary care. It should be ensured that the control steps are carried out by the most suitable bodies.