# Private medical consultation - €250!!



## jan (4 Mar 2021)

Got an appointment for a medical consultation - had to go private as those on the public system are not taking on new patients. 
its gonna cost me €250 for the 1st consultation - I almost had a heart attack. 
I knew it was gonna be expensive - last consultation I had privately was €200 - the one before that was €150. But it just keeps going up and up - my wages are not going up much over the last 20 years thats for sure. I know I didn't train for as long as these consultants but gee - shocking. 
I think this is just wrong. Its no wonder there is such a divide in the world. 
Any thoughts?


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## arbitron (4 Mar 2021)

It's a lot of money. The cost is influenced by a lot of factors, including the location of the consulting rooms (some of the rents are huge), length of consultation, the specialty, any prep work (e.g. reviewing scans beforehand), tests done on the day in the consulting room (e.g. my aunt got a scan at her private eye appointment recently and cost of scan was included - those machines cost a lot of money to run), number of other staff in the clinic (nurses, technicians, admin), whether this will be a one-off visit, etc.

The lack of price transparency combined with the huge information gap between doctors and patients make it very difficult for patients to properly assess the value and quality of services offered. 

It is a shocking system that should have been addressed a long time ago. People scream blue murder over water charges, carbon tax, etc. but there are very few protests about the health system. Private insurance is a rent-seeking enterprise that the state created, doctors and hospitals perpetuate (remember the public hospitals feed off the insurers too), and the public tolerate.


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## Steven Barrett (4 Mar 2021)

Yes, they are expensive but that is the cost you are paying for expertise. A doctor usually gets to the level of consultant about the age of 35. Considering they started that journey at 18, that's a lot of work and study to get there and they charge accordingly. If they have a huge demand for patients (a consultant client of mine is taking 2023 appointments at the moment), they charge more. It is no different to anyone else. Look at the price of builders and tradesmen at the moment. Look at the price of accommodation in Ireland over the summer. Supply and demand.


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## SGWidow (4 Mar 2021)

Jan,

In a civilised society, we should all strive for timely affordable access to healthcare where the delivery is based on need rather than ability to pay.

I find the justification of the current "supply and demand" system distasteful.


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## NoRegretsCoyote (4 Mar 2021)

arbitron said:


> The lack of price transparency combined with the huge information gap between doctors and patients make it very difficult for patients to properly assess the value and quality of services offered.




Irish courts seem to think that consultants should be able to perfectly prevent every negative outcome and that all failings should involve millions in payouts.

So insurance is also a huge cost depending on the specialty.


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## michaelm (4 Mar 2021)

If you are a taxpayer you will be able to claim back €50, which might lessen the sting.


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## Sue Ellen (4 Mar 2021)

jan said:


> Got an appointment for a medical consultation - had to go private as those on the public system are not taking on new patients.
> its gonna cost me €250 for the 1st consultation - I almost had a heart attack.
> I knew it was gonna be expensive - last consultation I had privately was €200 - the one before that was €150. But it just keeps going up and up - my wages are not going up much over the last 20 years thats for sure. I know I didn't train for as long as these consultants but gee - shocking.
> I think this is just wrong. Its no wonder there is such a divide in the world.
> Any thoughts?




As you were thinking of going public you most likely don't have health insurance but lots of policies these days include 50% cover for consultant visits in their day to day expenses.


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## jan (4 Mar 2021)

thanks for all your replies.. I didn't know I would get that much via tax back - so thanks for that - I do have private health insurance, so I can get €80 back. Notwithstanding all reasons outlined above, who could I make a complaint to? I still feel its outrageous.. the consultation will probably take about 20 mins going from previous experiences.. I just feel I should lodge my disapproval to someone... we Irish have a history of moaning but not being pro active - I think that should change..


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## jpd (4 Mar 2021)

Private consultants are free to charge what they want - the same as every other business in the country.

The main way to keep prices low is via competition - if their is a shortage of X, so that X can charge a high price, that will attract more people to become X and so force prices lower. Works in all walks of life - eg supermarket prices reduced when Aldi & Lidl arrived, taxis when Uber arrived

Of course, if you are an X, the best thing to do is to prevent other people becoming an X - by restricting entry by whatever means possible eg licensing, appealing against planning laws, having over-restrictive rules, limiting training entries, lobbying for laws to restrict entry

X's can always form an association with published public goals such as sharing knowledge but with a hidden agenda of keeping prices high - this is illegal but very difficult to prove in reality.

So, in short, there is no one to complain to


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## Susie2017 (4 Mar 2021)

Just to point out the consultant will be paying top rate tax on this income i.e 52% including the top rate of USC (self employed income), assuming they are also working in a public hospital. They will have to pay medical indemnity cover which could be around 30 K per annum, depending on their speciality ( the amount is more than that in many specialties e.g obstetrics). They will also have to pay their own secretary and the cost of their rooms, rent, heat, light, equipment etc. That means the consultant is likely taking home less than 100. Do you expect them to earn less than that after all of the training, exams, research, travelling/living abroad, on call etc that they have done to become experts in their speciality?. You should get back whatever your health insurance will cover plus 20% of fee via the med 1 form so that brings down the cost considerably.


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## noproblem (4 Mar 2021)

My son lives in Dublin 14 and his (very good) wooden electronic gate won't close automatically. Tried his best to do it himself as he's "handy" but nothing doing. Phones the company that installed it for the previous owners, explains his problem and they tell him a guy will call out to see what's wrong. Next day and near the time that was arranged the guy has a look, about 5 mins and explains the problem and that a part will have to be ordered, rings office for price and duly writes out an estimate for everything @€375.00 including his call out fee which was €150.00. Yes, he paid it that weekend when the job was done. My point being, the consultation fee was €150.00. Plumbers are around €75 call out fee, mechanics are similar and we won't mention washing machine, fridge, dishwasher, repair men/women.
Then again, what does a leak cost?


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## Protocol (4 Mar 2021)

Healthcare costs are very high in Ireland, they are out of line.

A GP in France charges 25 approx.

We pay GPs 25+25+10 = 60 for vaccinations.

The NHS pays GBP 12.58 + 12.58 = approx 30 euro.


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## Gerryobrien (4 Mar 2021)

You can't complain about this. You want to skip the queue, so you pay for it. Like you said, you'll get money back from health insurance and tax relief.
You might complain to the Govt about public waiting lists, which is where the supply or demand issue comes into it. New entrant consultants have been on lower pay than their colleagues since austerity measures. It is very hard to attract them to fill all the vacant posts as a result. If you don't have a consultant, you don't have extra outpatient clinics.
Like another commenter said, all professionals have a fee and that's life.
The fact that they may dispense their knowledge in 5 mins is irrelevant, as it is expert knowledge, gained by many years of hard graft. I'd feel much more confident if a consultant took a few minutes to diagnose me than an hour hemming and hawing over it.


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## elcato (4 Mar 2021)

This worries me from an inflation point of view all the same. My last consultant (within the last 2 years) was always 180 and was that price for a few years. If the bar is now 250 then it is a significant increase regardless of insurance or tax relief.


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## jan (4 Mar 2021)

Gerryobrien said:


> You can't complain about this. You want to skip the queue, so you pay for it. Like you said, you'll get money back from health insurance and tax relief.
> You might complain to the Govt about public waiting lists, which is where the supply or demand issue comes into it. New entrant consultants have been on lower pay than their colleagues since austerity measures. It is very hard to attract them to fill all the vacant posts as a result. If you don't have a consultant, you don't have extra outpatient clinics.
> Like another commenter said, all professionals have a fee and that's life.
> The fact that they may dispense their knowledge in 5 mins is irrelevant, as it is expert knowledge, gained by many years of hard graft. I'd feel much more confident if a consultant took a few minutes to diagnose me than an hour hemming and hawing over it.


I had no choice but to go private as all public lists either had a 3 yr waiting period or weren't taking on new patients! 
But you made a good point - I could complain to the Govt about the public waiting lists.. or even lack of.... 
Thanks again for all your replies.. still think its wrong - if we had a better health care system, we would not have this situation


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## jan (4 Mar 2021)

elcato said:


> This worries me from an inflation point of view all the same. My last consultant (within the last 2 years) was always 180 and was that price for a few years. If the bar is now 250 then it is a significant increase regardless of insurance or tax relief.


Thats exactly the point I was making initially - my private appointments have been ranging from 150 - to 250 in the space of about 5 years.. my wages have certainly not increased to that extent over the same period. Different rates of inflation - no comparison - yet we all live in the same country - its v unfair and wrong no matter how its justified!


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## Sue Ellen (4 Mar 2021)

elcato said:


> This worries me from an inflation point of view all the same. My last consultant (within the last 2 years) was always 180 and was that price for a few years. If the bar is now 250 then it is a significant increase regardless of insurance or tax relief.





jan said:


> Thats exactly the point I was making initially - my private appointments have been ranging from 150 - to 250 in the space of about 5 years.. my wages have certainly not increased to that extent over the same period. Different rates of inflation - no comparison - yet we all live in the same country - its v unfair and wrong no matter how its justified!




Initial appointments are generally €250 and follow-on are in/around €180.00.


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## Gordon Gekko (4 Mar 2021)

How does that saying go?

“If I do a complex job in 15 minutes, it’s because I spent 15 years learning how to do that job in 15 minutes. You’re paying me for those years, not for those minutes.”


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## tomdublin (5 Mar 2021)

Gordon Gekko said:


> it’s because I spent 15 years learning how to do that job in 15 minutes.


Yes but the public paid for your education.


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## Gordon Gekko (5 Mar 2021)

tomdublin said:


> Yes but the public paid for your education.



It didn’t really. The cost was covered many times over by taxes.

And the State now takes 52-55% of every incremental €250 from every high-earner.

Joe Public does very well from high earners.


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## Steven Barrett (5 Mar 2021)

tomdublin said:


> Yes but the public paid for your education.



And if the OP wanted to go the public route, she could go that route and wait 3 years. But she wants to go private and is therefore paying a private business. She is paying for an expert in their field, someone who has spent 15+ years to get to the level that they are at. They are going to be expensive, all experts are, no matter what area you are talking about.

Do you also say to guards "I pay your wages"


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## SGWidow (5 Mar 2021)

SBarrett said:


> And if the OP wanted to go the public route, she could go that route and wait 3 years. But she wants to go private and is therefore paying a private business.



What certain posters with, what I believe are very right wing views, fail to understand is that the OP does necessarily not want to go private...…...she wants her health concern addressed in a timely manner and so was compelled to go private.


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## Rosjohn (5 Mar 2021)

What's really shocking is to hear that Publicly employed Consultants in Public Hospitals can high handedly declare they're not taking any new patients!!
I thought the whole point of a public health system was that it was for everyone (albeit with waiting lists) ....


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## deanpark (5 Mar 2021)

If the consultant helps to cure an illness or detects cancer etc or gets you into hospital quickly then the money is well spent, not a lot in the scheme of things and soon forgotten. I know its tough shelling out 250e but your health is priceless.


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## Paul O Mahoney (5 Mar 2021)

deanpark said:


> If the consultant helps to cure an illness or detects cancer etc or gets you into hospital quickly then the money is well spent, not a lot in the scheme of things and soon forgotten. I know its tough shelling out 250e but your health is priceless.


Unfortunately that's the truth, I was given a public consultation date for a problem and had I not gone private I'd be dead, it was cancer.


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## Steven Barrett (5 Mar 2021)

Rosjohn said:


> What's really shocking is to hear that Publicly employed Consultants in Public Hospitals can high handedly declare they're not taking any new patients!!
> I thought the whole point of a public health system was that it was for everyone (albeit with waiting lists) ....



They don't. In the public system, a consultant just sees the patients on the list. They can literally walk from room to room all day seeing the next patient on their list. If someone told the OP that they aren't taking on any new patients, it was someone else in the hospital and not the consultant. I would have no idea why this other person would tell someone they are not taking new patients and not just put them on a very long waiting list.


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## ATC110 (7 Mar 2021)

I have experience of two well-known hospital consultants.

One of them told me their public list was "closed" and it would be €400 to attend their private clinic. Instead I was publicly referred by another consultant in the same hospital and had an appointment within 3 weeks.

The other was specialising in a niche area and was getting lots of private patients at €200 a time. They then increased the fee to €400 , for patients who largely were vulnerable and had little funds due to longterm illness.
They ask for the cash upfront in the consultation, taking out their wallet to put it in.

Their ethics, or lack thereof, are highly questionable.


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## ATC110 (7 Mar 2021)

RTE's Primetime Investigates broadcast an episode which trailed hospital consultants over a three month period to ascertain whether they were doing their contracted 39 HSE hours per week. 

None of them were and there was one who did an average of 13 hours a week despite being paid for 39. This is straightforward theft and they should be criminally prosecuted but it will never happen.

The main problem is hospital consultants have no line manager and are directly contracted to the HSE making them accountable to nobody.

Hence the arrogant preening God-complex that many of them have.


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## ATC110 (7 Mar 2021)

SBarrett said:


> They don't. In the public system, a consultant just sees the patients on the list. They can literally walk from room to room all day seeing the next patient on their list. If someone told the OP that they aren't taking on any new patients, it was someone else in the hospital and not the consultant. I would have no idea why this other person would tell someone they are not taking new patients and not just put them on a very long waiting list.


They do - I was told the public list was closed verbatim by the consultant


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## noproblem (7 Mar 2021)

If the above is true and there's nothing to say it isn't,  i'd love to know how anyone, political or other is going to tackle it. It will  take an actual consultant to come out and declare publicly what's going on and that it has to stop. Will that happen? You must be joking, sadly. Do consultanbts run the health service we have? Maybe they do.


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## Feemar5 (7 Mar 2021)

jan said:


> thanks for all your replies.. I didn't know I would get that much via tax back - so thanks for that - I do have private health insurance, so I can get €80 back. Notwithstanding all reasons outlined above, who could I make a complaint to? I still feel its outrageous.. the consultation will probably take about 20 mins going from previous experiences.. I just feel I should lodge my disapproval to someone... we Irish have a history of moaning but not being pro active - I think that should change..


When you claim tax back you will have to deduct the €80 you got from health insurance - so you will get a refund at whatever rate of tax you pay on €170.00


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## Gervan (8 Mar 2021)

Feemar5 said:


> so you will get a refund at whatever rate of tax you pay on €170.00


As far as I know, medical fees get only a 20% tax rebate


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## Rosjohn (8 Mar 2021)

Yep, 20%.


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## ATC110 (8 Mar 2021)

noproblem said:


> If the above is true and there's nothing to say it isn't,  i'd love to know how anyone, political or other is going to tackle it. It will  take an actual consultant to come out and declare publicly what's going on and that it has to stop. Will that happen? You must be joking, sadly. Do consultanbts run the health service we have? Maybe they do.


It is true.

This is why public waiting lists are so long.

It'll never be addressed-most of society are afraid of consultants including politicians, who also live in the same leafy areas and mix in the same social circles.

Their private practice is a valuable source of income for the hospitals they're based in so they're complicit in the wholescale theft of public money.

The consultants I referenced both have lucrative private practices and all appointments are within the working day, not evenings and weekends. They are contracted for 39 hours to the HSE and do not work nights.

There was a slew of calls to Liveline by public patients who have been on waiting lists for years the day after the programme was broadcast. The completely out of character muted response from the presenter was astounding.
If it had've been rogue tradesmen fixing roofs there would've been the usual populist hyperbole with name calling like "gurriers".

But when it's embedded dereliction of duty, discommoding of the public and theft of taxpayers money by "pillars of society" there's no comment.

And yes they do run the health service.


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## noproblem (8 Mar 2021)

ATC110 said:


> It is true.
> 
> This is why public waiting lists are so long.
> 
> ...


You have to remember that consultants are allowed to carry out their private work in hospitals so saying they're robbing taxpayers money is wrong, as is dereliction of duty. Politicians I know do not live in the same leafy suburbs either and most have only enough to get by on like an awful lot more. I'm not by any means running down consultants but we simply need more of them. I was out of circulation for quite a while over the past 6/7 months and wouldn't be on this earth only for the skill of the said consultants and owe them my life. Are they in a privileged position? Yes, they certainly are but would I ,or, could I do what they do? No way . I had private health insurance and make no apology for having it. I don't drink, don't smoke and imagine one of them alone could pay for that insurance. It's my choice to do this, others who think it expensive might need to remember this.


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## ATC110 (8 Mar 2021)

noproblem said:


> You have to remember that consultants are allowed to carry out their private work in hospitals so saying they're robbing taxpayers money is wrong, as is dereliction of duty.


No it's not wrong - this is obviously said in the context of them working less than their contracted public hours.

That is robbing and that is dereliction of duty.

Read my posts


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## noproblem (8 Mar 2021)

ATC110 said:


> No it's not wrong - this is obviously said in the context of them working less than their contracted public hours.
> 
> That is robbing and that is dereliction of duty.
> 
> Read my posts


If you say so and can show them not fulfilling their hours. In any case, it's getting away from the original posts concern


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## fidelcastro (8 Mar 2021)

Gordon Gekko said:


> It didn’t really. The cost was covered many times over by taxes.
> 
> And the State now takes 52-55% of every incremental €250 from every high-earner.
> 
> Joe Public does very well from high earners.


That's assuming payment was by cheque / card. Many seem to prefer cash for some strange reason. 
Heres hoping Irish people insist on paying by card to force tax cheats to pay their PAYE dues. So please use your cards/ phones for payment.


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## fidelcastro (8 Mar 2021)

jan said:


> thanks for all your replies.. I didn't know I would get that much via tax back - so thanks for that - I do have private health insurance, so I can get €80 back. Notwithstanding all reasons outlined above, who could I make a complaint to? I still feel its outrageous.. the consultation will probably take about 20 mins going from previous experiences.. I just feel I should lodge my disapproval to someone... we Irish have a history of moaning but not being pro active - I think that should change..


Complain to Joe Duffy. Then again, compared to Joe, a highly trained consultant doctor wages are a bargain


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## Gordon Gekko (8 Mar 2021)

fidelcastro said:


> That's assuming payment was by cheque / card. Many seem to prefer cash for some strange reason.
> Heres hoping Irish people insist on paying by card to force tax cheats to pay their PAYE dues. So please use your cards/ phones for payment.



I have never paid a consultant in cash or been asked to do so.


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## ATC110 (8 Mar 2021)

noproblem said:


> If you say so and can show them not fulfilling their hours. In any case, it's getting away from the original posts concern



RTE Primetime say so.

The 'original posts concern' is directly related to my point - nobody pays for a private consultation for fun, if every doctor worked the hours they are being paid for there'd be a lot less need for private consultations.

 Are you a hospital consultant by any chance?


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## fidelcastro (8 Mar 2021)

Gordon Gekko said:


> I have never paid a consultant in cash or been asked to do so.


Good, modern times Gordon. But not so long ago in jolly Ireland cash was de rigueur. I speak as one with relatives in such business.
The pandemic has, fortunately forced  lots of cash loving business to accepting card payments and into the loving arms of the taxman.  However we have a bit to go yet. And I do not begrudge Revenue their money

No man is an island Gordon!


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## noproblem (8 Mar 2021)

ATC110 said:


> RTE Primetime say so.
> 
> The 'original posts concern' is directly related to my point - nobody pays for a private consultation for fun, if every doctor worked the hours they are being paid for there'd be a lot less need for private consultations.
> 
> Are you a hospital consultant by any chance?


Afraid not, nor do I wish to be.


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## becky (9 Mar 2021)

Rosjohn said:


> What's really shocking is to hear that Publicly employed Consultants in Public Hospitals can high handedly declare they're not taking any new patients!!
> I thought the whole point of a public health system was that it was for everyone (albeit with waiting lists) ....


I assume it's a Consultant due to retire.


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## elcato (9 Mar 2021)

ATC110 said:


> RTE Primetime say so.


That's hardly an endorsement. RTE remind me of Bart Simpson's episode when he was an 'undercover' journalist.


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## Gerryobrien (9 Mar 2021)

Again, the issue of public lists being closed should be directed at the Govt, not individual consultants. There is a serious lack of consultants in Ireland. At some stage, the existing ones needs to close off their lists because it is ridiculous to expect them to accept the risk of patients waiting for 4 years to be seen for something that could be serious. There is a medicolegal burden there that needs to be discharged by the Govt establishing the necessary amount of consultant led teams and not passing the buck to waiting lists. This can only be addressed by restoring pay parity to new entrant consultants because why would they do the same job as their colleagues for less, and indeed do the same job with poorer pension entitlements than the previous generation?


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## Rosjohn (9 Mar 2021)

Do most Public Consultants only have 20 hour Public contracts?


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## Steven Barrett (9 Mar 2021)

Rosjohn said:


> Do most Public Consultants only have 20 hour Public contracts?


There are different contracts available to consultants, with differing salaries depending on whether they take private work or are solely doing public work. I had a quick search but couldn't see the hours required under each one.


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## time to plan (9 Mar 2021)

Gordon Gekko said:


> How does that saying go?
> 
> “If I do a complex job in 15 minutes, it’s because I spent 15 years learning how to do that job in 15 minutes. You’re paying me for those years, not for those minutes.”


It's like the mythical engineer asked to provide a breakdown of the $10,000 bill for simply pressing a button to solve an urgent production line problem:


Pressing button:$10Knowing which button to press$9,900Total$10,000


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## time to plan (9 Mar 2021)

Gerryobrien said:


> You can't complain about this. You want to skip the queue, so you pay for it. Like you said, you'll get money back from health insurance and tax relief.
> You might complain to the Govt about public waiting lists, which is where the supply or demand issue comes into it. New entrant consultants have been on lower pay than their colleagues since austerity measures. It is very hard to attract them to fill all the vacant posts as a result. If you don't have a consultant, you don't have extra outpatient clinics.
> Like another commenter said, all professionals have a fee and that's life.
> The fact that they may dispense their knowledge in 5 mins is irrelevant, as it is expert knowledge, gained by many years of hard graft. I'd feel much more confident if a consultant took a few minutes to diagnose me than an hour hemming and hawing over it.


You certainly can complain about this. A properly organised health system shouldn't have the waiting lists that exist in the Irish public system. When we moved from the UK, we simply couldn't get our child seen in the public system for a life-long (but thankfully not serious) condition that needs an annual review. The UK hospital provided a handover letter for the Irish GP. The Irish GP referred to the public hospital. It was impossible to get any acknowledgement from the hospital that the referral had been received, let alone placed on a waiting list. And I've spent my life working in or with first the UK and then the Irish public health systems, so I'm fairly adept at navigating the systems. The only way to be seen was privately, adn we are lucky enough that we can afford it without hardship. But I can complain!


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## ATC110 (9 Mar 2021)

becky said:


> I assume it's a Consultant due to retire.


No. The one who said it to me is middle-aged.
They're accountable to no one so can do what they like.


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## ATC110 (9 Mar 2021)

elcato said:


> That's hardly an endorsement. RTE remind me of Bart Simpson's episode when he was an 'undercover' journalist.


I'm no apologist for RTE but it's impossible to fault the findings of this investigation.

Several consultants were trailed for 13 weeks to provide an accurate average number of hours worked.

All fell short of their contracted 39 hours, the worst offender being an opthamologist who did an average of 13/39 hours a week.

Patients urgently requiring laser eye surgery-to the point of losing their ability to live independently-were interviewed and they had been waiting years for what was initially a minor and routine procedure.

No amount of undermining the source or excuse making justifies these people's behaviour. They should be criminally charged with theft and struck off the register.

What part of the hippocratic oath states to leave patients languishing while you steal from the public purse and simultaneously earn a private income.

The consultants who do this couldn't care less about the health of their patients; they're only interested in making money.


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## noproblem (9 Mar 2021)

time to plan said:


> It's like the mythical engineer asked to provide a breakdown of the $10,000 bill for simply pressing a button to solve an urgent production line problem:
> 
> 
> Pressing button:$10Knowing which button to press$9,900Total$10,000


Hmm, that engineer wasn't great at his maths tables as there's $90 not accounted for


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## time to plan (9 Mar 2021)

noproblem said:


> Hmm, that engineer wasn't great at his maths tables as there's $90 not accounted for


That's the client's problem.


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## becky (9 Mar 2021)

Rosjohn said:


> Do most Public Consultants only have 20 hour Public contracts?


No, they are 39 hours. Contract type B allows 30% private. A timetable of the 39 hrs should be agreed. 


ATC110 said:


> No. The one who said it to me is middle-aged.
> They're accountable to no one so can do what they like.


What's middle aged? He may be allowed to retire at 60.


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## ATC110 (9 Mar 2021)

becky said:


> No, they are 39 hours. Contract type B allows 30% private. A timetable of how these
> 
> What's middle aged? He may be allowed to retire at 60.


Circa 40 (life expectancy is not 120)


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## Gerryobrien (10 Mar 2021)

I was referring to the original query about being able to complain about what the private consultant is charging. I don't think there are grounds for complaint there, but there certainly are regarding the wider issue of waiting lists, having to go private, etc and I do think all these issues which do boil down to supply and demand go back to the Govt inability to administer proper consultant led care publicly.


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## ATC110 (10 Mar 2021)

Gerryobrien said:


> I was referring to the original query about being able to complain about what the private consultant is charging. I don't think there are grounds for complaint there, but there certainly are regarding the wider issue of waiting lists, having to go private, etc and I do think all these issues which do boil down to supply and demand go back to the Govt inability to administer proper consultant led care publicly.



Consultants being unaccountable, out of control and not working the hours they're paid for is a large part of the problem


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## roker (11 Mar 2021)

SBarrett said:


> Yes, they are expensive but that is the cost you are paying for expertise. A doctor usually gets to the level of consultant about the age of 35. Considering they started that journey at 18, that's a lot of work and study to get there and they charge accordingly. If they have a huge demand for patients (a consultant client of mine is taking 2023 appointments at the moment), they charge more. It is no different to anyone else. Look at the price of builders and tradesmen at the moment. Look at the price of accommodation in Ireland over the summer. Supply and demand.


the consultant earns that €250 in about 15 minutes, he may have taken years to get to that position but so do a lot of other specialised professions. a few years ago, I once attended a consultant and I was with him about 2 minutes enough for him to say my test were clear, this could have been done with a phone call and save me losing work, but he was after another fee which I refused to pay


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## Steven Barrett (11 Mar 2021)

roker said:


> the consultant earns that €250 in about 15 minutes, he may have taken years to get to that position but so do a lot of other specialised professions. a few years ago, I once attended a consultant and I was with him about 2 minutes enough for him to say my test were clear, this could have been done with a phone call and save me losing work, but he was after another fee which I refused to pay


In that situation, you shouldn't have been charged the fee to tell you the tests were clear. I had tests recently myself and got a letter confirming they were clear. No fee. Let's not pretend that every consultant does this. Like in every walk of life, you will get some who are greedy and will charge you for anything.


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## roker (11 Mar 2021)

SBarrett said:


> In that situation, you shouldn't have been charged the fee to tell you the tests were clear. I had tests recently myself and got a letter confirming they were clear. No fee. Let's not pretend that every consultant does this. Like in every walk of life, you will get some who are greedy and will charge you for anything.


I already paid him a fee to set things up,  but €60 for 2 minutes is pushing it a bit. A lot of people will not dispute for fear that something is wrong with them and don't want to cause problems


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## NiallSparky (12 Mar 2021)

ATC110 said:


> I'm no apologist for RTE but it's impossible to fault the findings of this investigation.
> 
> Several consultants were trailed for 13 weeks to provide an accurate average number of hours worked.
> 
> All fell short of their contracted 39 hours, the worst offender being an opthamologist who did an average of 13/39 hours a week.



How were they trailed exactly? A large part of the work of a consultant is done on-call or remotely.

Unless RTÉ were hacking their phones or getting their call logs then I don't think they have a leg to stand on with their assertion. It's not really proof of anything.


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## ATC110 (13 Mar 2021)

NiallSparky said:


> How were they trailed exactly? A large part of the work of a consultant is done on-call or remotely.
> 
> Unless RTÉ were hacking their phones or getting their call logs then I don't think they have a leg to stand on with their assertion. It's not really proof of anything.


Can't remember now but it wasn't a frivolous claim.

Consultants are a law unto themselves with no line manager. They come and go as they please unchecked. 

From personal experience, all consultants who do private work have appointments 9-5 M-F despite being contracted for 39 hours with the HSE. And no they did not work any nights. 

Do you have a vested interest by any chance?


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## SPC100 (13 Mar 2021)

Consultant worked less than 13 hours per week
					

RTÉ Investigates has found a failure by the HSE and hospital managements to properly implement the 2008 Hospital Consultants' Contract across acute public hospitals.




					www.rte.ie


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## Mocame (13 Mar 2021)

My mother was a senior nurse prior to her retirement.  She worked with a public consultant for a decade in one of the large regional hospitals and never witnessed this person see a single public patient.  This person just worked their private list - s/he was   never challenged.  My mum also witnessed others who saw very few public patients - far below their allotted public hours.   She is retired five years now but this was her consistent experience over her career.


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## ATC110 (13 Mar 2021)

Mocame said:


> My mother was a senior nurse prior to her retirement.  She worked with a public consultant for a decade in one of the large regional hospitals and never witnessed this person see a single public patient.  This person just worked their private list - s/he was   never challenged.  My mum also witnessed others who saw very few public patients - far below their allotted public hours.   She is retired five years now but this was her consistent experience over her career.


That is the norm unfortunately. This is criminal behaviour but no action is taken despite it being common knowledge


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## SPC100 (13 Mar 2021)

So what can we do about it?


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## Susie2017 (13 Mar 2021)

Totally misleading to say it is the norm. The vast majority of consultants hold type B contracts which do not permit them to do any offsite private practice. Look at publicjobs.ie you will see that virtually all posts that are advertised or were advertised in the last 13 years are type B posts. Anyone holding a type A contract can claim no private fees at all. RTE followed several consultants who probably held old type II contracts. These have not been issued since before 2008 and even then were the least common contract held. A type I contract was the most common pre 2008 which also forbids off site private work. So please don’t make accusations that are not true. Consultants do have line managers they are called clinical directors and hospital managers and they do proactively ensure that consultants adhere to the terms of their contracts. Any anecdotal experience that people recount here may have occurred historically but do not occur now. The vast majority of consultants fulfil all their contracted hours in public hospitals, often way beyond their 39 hr week. Many consultants choose to work in private hospitals exclusively and therefore do not hold or may resign from their public hospital jobs prior to doing so. Some hold type C contracts which they must apply to their hospital manager and subsequently obtain CAAC approval. This contract reduces their public hospital commitment and salary, but these are not commonly sought. If someone is breaching their public contracted hours then they can be reported to their hospital manager/ clinical director and it will be acted on.


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## fungie20 (13 Mar 2021)

While technically consultants may have line managers, in reality, they can pretty much do as they want. I don't mean this in terms of public vs private but while in the public system. Some see lots of patients, some choose to not see a lot of patients, some focus on teaching, some on research. There seems to be little to no standardisation.


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## jan (13 Mar 2021)

just catching up on replies now - so, is it possible that I was told a lie with regards to public list's being full so that I would have to go private?


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## Rosjohn (14 Mar 2021)

Look up Consultants on the VHI website.
I've yet to see one that hasn't 3 or 4  Hospitals or Practices listed.
Usually a Public Hospital and a Prcatice at the same Hospital - presumably for Private patients  and then 2 or 3 Private Hospitals.


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