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Dublin: 10 °C Thursday 23 May, 2013

General Practice in Ireland at “breaking point”, says IMO

The Irish Medical Organisation said that budget cuts ‘could end the capacity to introduce universal GP care’.

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GENERAL PRACTICE IN Ireland is at “breaking point”, the Irish Medical Organisation has warned.

It made the comment while addressing Department of Health officials at an oral submission on the review of the operation under the Financial Emergency Measures (FEMPI) in the Public Interest Act 2009.

The IMO said that the imposition of further cuts, on top of recent severe cuts in financial support for GP services “threatens to destroy the fabric of the Irish GP system”.

Waiting lists

IMO GP Chairman, Dr Ray Walley said that decisions taken under the act yesterday “may well herald the introduction of waiting lists for patients for the first time in Ireland and the unavailability of GP services in certain parts of the country”.

He added:

Further cuts in payments to GPs will mark the end of any capacity to introduce Universal GP Care in Ireland in the foreseeable future.

Dr Walley said that additional cuts “will devastate general practice and will, in turn, have adverse effects on the most vulnerable patients who are dependent on the services of their GP”.

The IMO emphasised that unless general practice is protected, “waiting lists are inevitable”. It said that general practice “will lose the capacity to meet the needs of patients and this will lead to significantly increased referrals to other services which are already under pressure”. GPs believe the greatest impact of any cuts will be the frail, the elderly, mentally impaired, children and those with literacy problems, said the IMO.

They also believe that attracting GPs to rural and disadvantaged areas is now a critical issue.

In the long term, further cuts “will virtually guarantee that universal GP care will not be possible for at least five years”, added the organisation.

Dr Walley said:

There is another way to meet the strict budgetary limits imposed by the State’s funders in a proportionate and fair manner. The challenge is to look at new and innovative ways of maximising our resources and using them in a way that meets patient needs and provides greater value for money.

Read: Government plans free GP care by 2015, universal insurance by 2016>

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Comments (37 Comments)

  • Oh you mean the system where we as a middle income family cant afford to go to the GP, while others get it for free?

    Be gone pets!

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    • Talk about a misleading article , doctors do a fine job in this country and i have nothing against them personally ,they do provide a service unlike solicitors who create problems so they can profit,but you say they are at breaking point they would not know the first thing about it.

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    • I think we’re gona need a breakdown of how much the state actually forks out for visits by medical card patients to take this in any seriousness.. its ?60 to visit my gp, I don’t think I’ve ever been with a gp for over 10/15 minutes. The availability of GP’s is far from the problem its the cost of them that’s unsustainable ..

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    • well said , this coming from an org that signed off on a 20 million pension pot for its CEO. Yesterday the pharamacies was suggesting their members were bound for the soup kitchens becasue the government was denying them money from passport photos with the new licences, what next teachers paying too much tax on grinds ;-0

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    • Brian. So true. We need a system where everyone has a medical card but EVERYONE pays €15 to use it. We need to level the playing field between the unemployed and the squeezed middle

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    • agree 100% , I have nothing against anyone out of work and claiming free health care , I’m also in the middle class trap , spent over 200 euros over Christmas bringing my kids to the doctors , at present I probably need to go to the doctors but just can’t afford it , dreading if one of my kids needs to go back to the doctors before pay day. I have never seen a quite doctor’s surgery ever and they are struggling ? ,

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  • They should inform and screen patients who have non-medical issues so that they don’t have to pay the GP for a referral to, for instance, a psychologist. NHS did this and it was effective in reducing waiting lists as they found a large proportion of patients were seeing the GP as a means to be referred onwards for mental health issues.

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  • And this warning coming from the IMO? The outgoing chief executive is receiving a gold-plated retirement deal worth nearly €10m. Anyone surprised it cost that much to visit a GP? They have some nerve even speaking in public.

    Needed to go to Dub Doc last night, €70 cash just to be told what I knew and get a script for some antibiotics.

    Maybe if they didn’t kick back as much to their union, the general practitioners cost wouldn’t be so high and the cost to the public wouldn’t be as restrictive.

    I feel like I am at the bottom of pyramid scheme!

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  • Shop around for your GP (Dublin anyway) 35 quid for mine in Dublin 8! may not be award winning but grand for the usual problems.

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  • Poor darlings, the highest paid Gp’s in the world. But hey, it’s Ireland!

    Among the highest paid politicians in the world
    Among the highest paid teachers in the world
    Among the highest paid civil servants in the world

    A small island of 4 million people in recession, hillarious

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  • correct me if i’m wrong but i heard that only a certain number of GPs are allowed to take on medical card patients and are thus getting paid a massive amount of money by the government. Other GPs are then forced to up their prices in order to keep afloat. If this was deregulated and any GP could take on a medical card patient, would this not balance out the demand and drive costs down?

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  • Ah me heart is pumping piss for them. Boo fecking hoo. I signed up for a gp service with a €30 fee per month for a family if 5 . Unlimited visits. It’s one direct debit I love to see leaving my bank account. My previous gp was a money grabber €60 a visit. Bye

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  • Inevitable? I rang the Midoc service over the holidays for my sick daughter and was told firstly there was nothing they could do, and secondly that the earliest they could see here was five and a half hours later….. Useless service.

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  • Sean 10/01/13 #

    I wouldn’t mind paying for the service that is worth paying. The service provided by the GPs is like going back in time 200 years! They have no equipment such as ultrasound or blood testing that can return the results almost immediately and that’s a disgrace. Surely if I become ill my blood has to be tested immediately and not the NEXT DAY!? If a woman is pregnant ultrasound scans should be done, without extra cost to the patient because it’s the way it’s done elsewhere in the world! I could go on and on here but the bottom line is that I don’t see any point paying €60 for a friendly chat (in most cases) to doctors who have no necessary equipment and never take you seriously on the first visit.

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    • GP’s do absolutely nothing . Most don’t even have basic resus eqpt and haven’t a clue about it. All they can manage are a flu at best. All that they do is copy prescriptions of the consultants and refer patients like a traffic policeman !!
      They don’t have the ability or eqpt to manage emergencies. We pay €60 for this !!!! No wonder the A/E are burdended .

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    • em zulu, that’s kinda the point.

      GP = non-emergency care, not a more comfortable place to get an x-ray and certainly not the place to get resuscitated. If you’re sick or sore, but functional, you go to the GP. If you broke your leg, inhaled smoke, or are having a heart attack, you go to Accident and Emergency.

      If you need a referral, you go the GP and they refer you up the chain. They are primary care. When you’ve been discharged from hospital, you go to your GP to get your prescription topped up afterwards. This stops hospitals from being clogged up with sick people that don’t need to be there, and keeps old biddies with a cold out of A&E.

      If you want to talk about the cost, that’s fine. But the primary care model is best from a care perspective, as long as the doctors involved aren’t complacent in their diagnosis. It might seem like a racket for writing anti-biotic prescriptions, but they are there for the 1 in 1000 patients where something serious is actually going on.

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    • Disgrace? Nowhere in the world can GPs take blood tests and have the result the same say,… They’d need a lab on site for that. How much would it cost to see a GP then if they had to stay profitable while paying for a lab and lab tech? Same goes for the scans, although in actual fact alot of the new generation of GPs are coming through with qualifications in ultrasound, etc that aren’t part of the traditional job description. Certainly not like 200 years ago. The job of a GP is primarily disease prevention and management of chronic stable illness. Acutely ill patients need to go to the emergency department. If someone knows that they are ill to the point that they need blood test results within a few hours then, they should also realise that to the GP isn’t where they should go. Not a perfect system but that’s life.

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    • Spot on Ronan. ALL GPs have resus equipment. By law. All GPs have spent months working as SHOs in the ED during their training. Some people misinterpret what the role of GP is.

      Also, the bill to pay a GP is high, yes. Sometimes up to 60 euro. You don’t hear people complaining that women have to pay over 100 euro to get a haircut! The cost to see a GP pays for the doc, nurse and receptionists wages, not to mention utilities bills. GP practises are businesses and as such have to remain viable

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    • You see Alan most people are thick and ignorant when it comes to any position. Everyone is an expert at everything these day – Everyone is a doctor, economist etc. .

      They should leave their opinions elsewhere

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  • I have no pity for doctors. South doc have the ambulance service at breaking point down here. They cant be bothered to go out so they tell the patient to phone an ambulance. That patient then had to be taken to hospital putting more pressure on the emergency department. When all the patient wanted was to see a doctor. Total waste of money.

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  • Poor GPS can’t milk that gravy train anymore – €50 for 5 mins ‘consultation ‘ – a legalised racket

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  • As bad here in states. I can’t get allergy drops w/o seeing the ENT. Its a freaking joke/ripoff. Was in there for a few secs and all they practically talk about is holidays!! Just checked my insurance and they submitted a bill for $562. Insurance instantly discounts $315 off. I tell ya ill be calling them tomorrow!
    Had a physical last year at GP. Insurance covers all of that here as its preventative. Also the blood work. Looks like physical was $227 billed to insurance, who knock off $101 then pay the rest. The bloodwork billed was $265, discount of $229, they paid $35. Got results next day.

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  • bring in a big cooperation from overseas who offer a cheaper service and can avail of our lower corporate tax rate and excellent conditions for tax avoidance. That would bring the price down and make the service more available. strange how is hasn’t happened already?

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  • If you have a insurance claim for a broken leg/arm etc a Dublin Doc will charge 490 eu for a letter saying yes the arm/leg was broke, The Doc probably doesn’t even notice it going into his bank account, another thing that should be looked into is private patients payments, very few would think of asking for a reciept after a visit to doc. I will say no more on that one.

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  • what about the nurse pay been cut again, I think the doctors in this country are on enough money!people would want to do some research and they woukd discover that doctors work in a private practice which they get paid for, work in hospitals or even private hospitals ghey gwt paid for that qnd also they get a percentage of each prescription thay write out! im greatful to doctors but I am even more greatful to the nurses as they are the ones who do all d hard work, dey are the ones who know the patient’s by their first name,they are the ones who get abused atleast once a day and they are the ones who show they care! the government and the hse would want yo get this situation sorted before it gets out of control….

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  • GPs are parasites , 50€ on average for a referral , 10€ to write a weekly cert for people out on long term sickness, greedy, like all so called professionals they believe they are entitled to super wages for the work they do, no your not, a fair wage only,

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    • Did you sweat for 2 years studying for your leaving cert and then spend 12 years training for your job? There are few professions which involve that amount of learning. The majority of cases might be simple, but it’d hardly be fair to charge people on the basis of how sick they are, now wouldn’t it?

      GPs live in your community, pay rent light and heat, pay staff, and have big business loans from when they bought the goodwill in a practice after qualifying. They don’t walk out the door with a ball of 50s in their pocket.

      Sure, a GP of 40-50 is well paid and comfortable, but they put off a lot of comfort (and their lives) early on so that they can complete the 1/5 of their adult working lives they spend training, followed by another 1/5 paying for the chunk of the practice they bought into.

      Tell me why someone would invest so much time money and effort, just to work for 50K per year? They wouldn’t. And then there would be no doctors, or at least plenty of bad ones, because it would be a daft career choice filled with mediocre performers.

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    • Ronan, 7 years study subsidised by the tax payer, but fair play , it can’t be easy , but it’s not right to charge 50€ plus for this service to be referred on to the specialist, or to charge 10€ for a doctors note for people on long term sick,

      Reply

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