TV Participants Wanted: What Are Your Thoughts On GP Fees?

I don't see any point in criticizing the doctors. The nature of the Irish health system has long been that two thirds of the population pay for GP care and then pay an extra whack for any medicines they need; whilst the other third pay nothing. That's the way it works. If I call out a plumber, visit a solicitor or phone my accountant, whether or not the problem is resolved to my satisfaction, I receive a large bill. It's often more than I was hoping it will be, but tough - I still have to pay. Personally, I prefer the NHS system, where - unlike the French system - the doctors have no incentive to over-treat, over-investigate or to give one patient more time or attention than another simply because they're paying. The NHS is far from perfect, but general practice over there is at least equitable.

In summary, I repeat that in my view, it's the healthcare system that is at fault - not the doctors who are obliged to implement it whether they like it or not.

Clare, Wexford
 
Unfortunately GPs are answerable only to their peers. This is where the problem arises from.

I had a child to the Doc recently with a chest infection. I have a bit of medical knowledge and could clearly see that the child needed an antibiotic. (Basic diagnosis is not rocket science)

Anyway he told me the child didn't need one and sent me off. €40. The next morning I deliberately brought the child back to him and whaddyaknow, immediately gave me an antibiotic. No apology or anything. Wanted to charge me another €40. I laughed and headed home.

Another thing which really bothers me is this; How many readers of this forum know of someone (mostly elderly people unfortunately) who were treated for months or even years with different antibiotics by GPs for various ailments, and then to discover they actually had cancer all along. I have never heard of GP been held accountable for misdiagnosis in a case like this.
I personally know of 2 who have since died. If their cancer had been diagnosed early, I'm quite sure they would be here today.

C. Donegal.
 
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My doctor charges €60 for an initial visit, which is a bit much if you've just popped in with a throat infection or a bug that's going around and all you need is a prescription and a cert for work (5 minutes max). To be fair to him he is very good about not charging for a follow up visit or only charging half price. I do think, though, that €60 is far too much for a routine diagnosis and a bit of discretion should be used here.

I think it's going to get to the stage where people will just put off going to the doctor until they absolutely have to in order to save money, resulting in further health problems down the line.
 
I think it's going to get to the stage where people will just put off going to the doctor until they absolutely have to in order to save money, resulting in further health problems down the line.

My GP told me that visits are way down since the recession started - its not like people suddenly became healthier, its for exactly the reason you state Liaconn.

In saying that, I believe many GP visits are not necessary, but one must go in order to get a cert for work. Last time I needed a cert I did not need a medical diagnosis, I knew I had a bug that was going around, i knew I did not need an antibiotic, I knew it was just a case of sweat it out for a few days - but I needed the cert for work so 60 quid was spent.
 
I think the cert business is a big part of the problem. If you're dying with a cold, you know its just a matter of staying indoors and letting it take it's course. No need for a doctor's diagnosis there. But you need the cert, he can't give it to you without making sure you really are sick (if he's an honest doctor!) and therefore you have to pay €60 just to be told 'yes, its a bad cold alright, I'll give you a cert until Thursday'. Maybe there should be some kind of a sliding scale of charges for an initial visit, although I suppose that could be open to arguments from patients. What do other people think?
 

You see youre paying for a professional opinion, so if the opinion is just 'its a bad cold' thats just as valuable an opinion as 'this is a complicated problem that we need to treat by doing the following....'. But it feels very unfair that a 5 minute visit for a cert for work is charged full price.

I dont think you should have to pay if you are just being referred on.
I also think that people should be allowed to self refer to consultants (I know some orthopediac surgeons are allowing this now). This business of needing a referral letter for a consultant is just a money spin in a lot of cases.

I dont think you should be charged full whack for repeat prescriptions or certs for work.

I also dont think you should have to pay to get x ray or test results that have been sent back to your GP - surely they could just phone you with the results and not make you pay for the pleasure (especially when youve already paid the GP to be referred for tests or x-rays!!).
 
If this kind of stuff is happening, then it should be reported to the Medical Council straight away.

My GP charged me €40 for a recheck on my blood pressure involving a change of medication, and advise on a simple head cold yesterday. He has explained to me right from the start that finding the right BP medication involves quite a bit of trial and error, and repeat visits and variations will be necessary.
 
A little off topic but probably relevant:
Did I read very recently that some nurses will shortly be able to prescribe medication? Maybe this is just in hospitals. But does this move not clear the way for simple perscription drugs to be issued without doctors fees?
 
I mentioned some of the topics of this thread to a doctor I know (not my GP) and she basically said, “If you don’t like it, go to another doctor”.

But I said, that my GP has closed their books to all new patients and she said, “Yes! So have I”

I think we need a lot more doctors here practicing to add a bit of competition, patient respect etc.

Am happy enough with my GP apart from the fact that an appointment can happen anytime up to 3 hours after scheduled time.

How hard is it to keep a diary of appointments and keep to it.
If emergencies arise (seemingly every day) allow some time in the day for emergencies.
 
The number of Irish Doctors allowed to train each year is fixed by the (I believe) the Medical Council.
Well there we have the root of our problems.
As long as this is the case, we will have a cartel.
 
I used to go to a GP who was constantly thinking up reasons not to charge people, 'no, you were kept waiting for ages', 'that's alright, sure it was a simple matter' etc. His wife owned a Chemist shop beside the surgery so people used to make sure to get their prescriptions made up there in order that he got some financial recompense.

Unfortunately, he left the practice to return to college .
 
In the last six months, my husband has visited both his GP and 2 consultants, all of whom have increased their prices by at least 10%. Outrageous. He has to visit the consultants on a twice annual basis, and pays at least €140 on each visit for approx 15 mins. The GP basically organises blood test documentation and writes out the same prescription for the ongoing ailments. A trained monkey could do the same. I've given up on GP's - got my initial prescription for ongoing ailment and now buy over the counter on the Continent, for a quarter of the price. My last GP spent the appointment updating his laptop computer - never once looked at my or asked general questions about health and well-being. Cartel it is - and the sooner we can break it up, the better!
 
In my local GP practice – the fees for private patients is €55 per consultation, €10 for repeat scripts, and irrespective of whether one is a private or GMS/GP visit cardholder €25 for practice nurse consultation and to have bloods taken, and a charge schedule for male and female health and travel vaccination charges. The annual flu vaccination programme is also being currently being rolled out within the practice for vulnerable groups at a charge of €35 per private patient – although it is free to GMS or GP visit cardholders.

If you need a sick note for work that will cost a private patient €10 and if you require a DSFA cert the GP will receive a fee of €8.25 from the DSFA for each cert they complete and €44.44 per DSFA medical report.

We have all heard of the payments GP’s received for so called “ghost patients” under the GMS – but GP’s also receive HSE grants as far as I know to employ practice nurses and secretaries when they are participating in the GMS – so why does GP’s levy a charge on cardholders to receive services from a practice nurse when they are receiving grants to employ them under the GMS system maybe something that warrants further investigation.

We also hear that the H1N1 vaccination is also going to be provided by GP’s and that the HSE is going to pay a GP €10 for each vaccination – but my question is whether these GP’s are going to levy an administration charge on private patients so that in addition to receiving the fee from the HSE they will receive a fee from the patient for receiving and administering this vaccination.

We have heard within the health strategy 2001 government vision to strengthen primary healthcare in Ireland so as to ensure that healthcare is delivered in the most appropriate setting ie. primary care environments as opposed to acute hospital care. This strategy was suppose to promote an integrated approach to delivering primary healthcare services by 2011 with the Strategy also identifying that services that were and still are currently provided in hospital services could be provided within a primary healthcare setting. We are now coming to the end of 2009 and my question is how many GP cooperatives has there been delivered under the Primary Health Care Strategy? What is the broad range of services currently provided in GP practice? We obviously have GP’s and practice nurses who provide a minimal range of services and who continue to act as gatekeepers for access to secondary health care – but apart from those provided by private healthcare providers we don’t have public funded minor injury units in primary care, and are far from achieving a model of all services under one roof from community mental health services, social workers, dieticians, speech and language services, home helps, health care assistants, chiropodists, physio, OT’s, psychologists or minor investigations. While government and Mary Harney may profess this to be their vision – we all know that our health infrastructure, nature of GP and primary care system or even our direction in health policy does not support such a model of delivery.

Another poster raised the issue of the medical council – there was an old saying – “there is no accountability in self-regulation”…. whether that person is a doctor, solicitor or accountant. The board of enquiry in the medical council is now composed of both professional and lay members of the public and how effective this new composite will be in terms of delivering greater accountability in this profession is something that maybe will warrant future investigation.
 
I actually suspect that when the income levy was introduced a lot of GPs and Consultants just upped their fees, passing it on to their patients who are already paying the levy on their own salary.
 
When I was pregnant I did combined care which means you get free GP visits. my GP told me I got a maximum of 6 visits for free and that this included one post natal visit.

I visited him once for a social welfare cert when I was unable to attend work and he counted this as one of the visits. Also attended for a problem which was pregnancy related in a way but not a normal ante natal visit and he charged me 50 euro. He told me I had run out of visits 4 weeks before due dates and advised that I should ask to be induced early because if I had to see him again before baby was born he would have to charge 50 euro per visit.

Needless to say this person is no longer my GP