herald

Wednesday 22 November 2017

GPs raking in €500 an hour

GPs are earning up to €500 an hour, a Herald investigation reveals today. Patients in Dublin are still being charged up to €70 per GP visit, despite household incomes being decimated.





A survey of 14 practices by the Herald showed the price for a simple consultation varied from €50 to €65.

In addition, a recent poll revealed 11pc of respondents said their GP was charging €65 or more for a visit, including 2pc who said fees were €70 or more.

Health Minister James Reilly (pictured) admitted today that people with health insurance are bypassing their family doctors in favour of already overcrowded A&E departments because of “the barrier of a fee”.

“Here's the paradox if you like, that which is proven to be the most efficient and cost effective, primary care or general practitioner services, has a barrier of a fee. That which is most expensive is free. You go the hospital,” the Health Minister said.

A member of the Irish Association of General Practitioners (IAGP) even admitted to charging different prices for the same service, depending on whether the patient was well off or not.

Stephen McMahon of the Irish Patients' Association (IPA) urged people to challenge their doctor if they felt they have been billed too much.



Slow

“We're now at a time of such economic pressure that patients really should challenge their family doctor if they're being asked for increases, get them to justify it,” he told the Herald.

GPs have been very slow to bring down their fees, Mr McMahon added.

“There is only one practice that we know of (in Dublin) that reduced fees significantly.

“That is over in Park West. He dropped his prices from €55 to €35 for a consultation.

“He's the only GP that made a significant reduction,” he said.

Mr McMahon pointed out that family doctors could take in up to €500 for an hour’s work, depending on how many patients they saw.

A recent report compiled by the IPA showed each of the country's 2,244 GP surgeries earned an average of €212,950 from medical card holders alone in 2009.

However, the IAGP said that doctors' incomes had fallen in recent years.

Fianna Fail health spokesman Billy Kelleher said it was important for GPs to realise “there is a change in circumstance out there”.

Many people who do not qualify for a medical card are still in financially difficult positions, Mr Kelleher said.

He added that Health Minister James Reilly needed to highlight the need for doctors to play their part to ensure there is a competitive system in place.

A Dept of Health spokesman said the minister had no role in regulating private GP fees.

However, costs to the State of the medical card and similar schemes fell by €34m in 2009 and €44m in 2010, he said.

Dr James Stacey of the IAGP said his income from medical card holders has dropped by about a third in the last three or four years.

However, consultation fees for private patients are a “very flexible commodity”, he told the Herald.

Mr Stacey said he “would not be in favour of having a set fee” for everybody “for the same thing”. He added that, “if a person is well off, you might charge a bit more”.

“It's not like going in and buying a loaf of bread in a shop. It's a very elastic thing,” Mr Stacey said.

Asked how a GP would know the financial circumstances of patients, he replied: “You would know if they are quite well off or barely scraping along.”

The Irish Medical Organisation (IMO) and the Irish College of General Practitioners did not comment on the issue.

The IMO said, “due to existing competition law” it was not permitted to comment on GP fees.

In France, a visit to the GP costs about €22 and €33 for a specialist such as a dermatologist. In the UK, a visit is free on the NHS.

In October, the head of the European Commission review team to Ireland hit out at the size of our medical fees, saying he would pay half as much to see a GP in Brussels.



Cheap

“I am living in Brussels, which is not at all a cheap place to live. I pay half the price you pay when you go to see a GP,” said Istvan Szekely.

Mr Kelleher pointed out that the changes to the medical card system could lead to lower prices.

It had been a sheltered area in which doctors tendered to be allowed treat medical patients.

This is no longer the case following changes recommended by the bailout troika, Mr Kelleher said.

He believes the move will lead to greater competition and could ensure GPs reduce their prices.

“It will allow any GP to set up in an area and to treat medical card holders. That is a welcome development,” Mr Kelleher said.

He added that he would he “hoping and urging” doctors to understand that patients are under huge pressure and they should “reflect the new reality that is out there” in their prices.

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