SOME DOCTORS HAVE been accused of wrongly charging women for their maternity care, contradicting the free scheme under the HSE.  

Multiple women who spoke to The Journal said they were charged €70 for basic appointments that are meant to be covered by the State.

One woman described how she had to pay for four GP appointments during her pregnancy, while another with a history of miscarriages said that her GP charged her because he said he wouldn’t get the HSE fee if she had another miscarriage.

Included in the Maternity and Infant Care Scheme is an initial examination, and five further appointments, which alternate between GP visits and maternity hospital visits.

‘Tax on women’

Caroline experienced fertility issues and multiple miscarriages, which her doctor was aware of.

When she became pregnant again, she visited her GP in South Dublin, where she was asked to pay €70.

She says the doctor told her that she was charged because, in the event she miscarried again, he wouldn’t get paid by the HSE for providing the full scheme. 

Under the scheme, GPs get paid €38.42 for the first visit and €27.67 for any after that.

In a statement to The Journal, the HSE said: “Where complete services are provided, a fee of €242.85 is payable to GPs for first pregnancies and €270.52 for all other pregnancies.

“Each element of the total fee will be paid on the basis of the professional service provided, i.e. no payment will be made where the appropriate professional service is not provided.”

The €70 appointment involved very little, said Caroline, as a pregnancy test wasn’t required. She’d had an early scan to check on the health of the baby due to her history, but was under the impression she still had to attend her GP so that she could choose a maternity care package.

She said the doctor was “blunt” with her about the reasoning behind the charge, despite knowing her previous experiences of pregnancy. 

“You’re in a very vulnerable situation … it really feels like some GPs take advantage of that.”

Caroline compared the charges to a “tax on women”. The disparity in fees and information provided to women has caused inequity, she says.

“There has to be conformity across the board, so that different women aren’t getting different levels of care or different financial penalties.”

Registration fees?

Regardless of whether women have a medical card or GP card, they are entitled to the scheme.

Deirdre told The Journal that she paid for four GP appointments during her pregnancy.

“I paid €70 to get confirmation that I was pregnant, which I already knew. In fact, the GP just confirmed it on the basis of me having said I weed on a stick and that I hadn’t had a period in eight weeks.

“[The doctor] then explained private versus public maternity care – which a quick Google had already explained.”

Deirdre says she was told the scheme didn’t cover the first appointment.

This is contrary to the information on the HSE’s website, which states: “If you are pregnant and you are ordinarily resident in Ireland you are entitled to free maternity care under the Maternity and Infant Care Scheme.

“The diagnosis of pregnancy forms part of the Scheme.”

Rachel told The Journal that she was also charged for her first appointment.

“The receptionist firstly tried to tell me that the appointment was charged for to ‘confirm my pregnancy’. I told them I already knew I was pregnant and that I wasn’t paying a full GP charge for a pregnancy test. 

“The receptionist then tried to tell me that the first appointment was actually charged to ‘register me with the maternity hospital’ and to sign me up for the ‘combined care’.

Rachel says she had already registered with a maternity hospital online for free and scheduled an appointment with them.

“The receptionist was visibly uncomfortable with my questioning and left her desk and didn’t return. As I was refusing to pay, I left the practice.”

Women also reported being charged for appointments for minor illnesses that they believe were connected to being pregnant.

However, the HSE said: “Care in respect of illnesses which are co-incidental with but not related to pregnancy do not form part of the Scheme.

“Where additional visits are required by patients suffering from major conditions e.g. diabetes, hypertension, a fee of €27.67 per visit, subject to a maximum of five visits, will be paid.”

Review and refunds

Social Democrats leader Holly Cairns called for an “immediate review” by the HSE of these complaints.

“If it is found that eligible patients have been wrongly charged then full refunds must be issued without delay,” she said.

“It is difficult to understand why expectant mothers would be charged for prenatal visits when virtually all GPs have agreements with the HSE to provide services under the Maternity and Infant Care Scheme.”

She said that Health Minister Stephen Donnelly should issue updated instructions to GPs.

“This incident highlights the urgent need for the full implementation of Sláintecare. These kind of situations would not arise under a universal healthcare system where everyone would be able to access the care they need without charge,” Cairns added.

The Labour Party’s health spokesperson Duncan Smith said that the situation is unacceptable. 

“One of the fundamental pillars of our health system which we can be proud of is free Maternity Care.

“I’m am astonished that any GP would make a mistake in this regard.

He also called for the women affected to be refunded, and for a reporting mechanism to be put in place to prevent future issues.