# Doctors (GP) Fees - No recession in my surgery



## Niallymac (1 Jul 2009)

Over the course of the last couple of months, between myself and the kids, have had 4 visits to the surgery. 60 quid a pop. Speaking from my own experiences, amongst me and maybe 20 friends, I don't know anyone that hasn't taken some sort of salary cut in the last year (taxes aside). Yet the GP waltzes merrily along charging the same prices as before, and they were a rip off even in boom time !

Price deflation is the only thing that can drive competitiveness, and much of the economy is doing what it has to do in order to cut its cloth etc. Has anyone out there witnessed any price deflation in their local GP surgery ?


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## GreenQueen (1 Jul 2009)

While I haven't experienced a reduction in fees I've found that my GP (and those in their practice) have been extremely considerate of my situation.

According to the HSE there is a 16 week waiting list for medical card applications in Dublin North.  I had to visit my GP due to illness but my medical card wasn't granted at that time and they waived my charges due to financial hardship along with writing a letter to medical card section requesting an urgent review.

I've since been granted a medical card.  I would say that the reason why there is no reduction in GP private fees is down to the increase in medical card patients.


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## DavyJones (1 Jul 2009)

My doctor is sound. My little son went through a stage of picking up every thing that was possible, it it had  "itis" at the end of it, he got it.

When we would bring him to the doctor, every third or so time, he would not charge us. Mostly he would say, it is a virus, nothing I can prescribe will do any good and he would advice on how to treat him. Then he would let us on our merry way, 5 mins later and with the same amount of money we had going in.

I love that guy.


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## Towger (1 Jul 2009)

My wife has just changed her and the children's GP (I have not seen one for almost 30 years) for this very reason. The last straw was earlier this year, when she went to get one of our children's 'free' vaccinations. When the day came, the little one had a rash. The GP decided that she was not well enough for the jab, and changed €60 for the pleasure of the visit. As my wife did not have the money on her she had to go to a ATM to get it out!


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## CharlieC (1 Jul 2009)

Last month Ireland had a chest infection 60 euro GP visit and 40 euro prescription
A week later still not gone.
Walked into UK health centre, they took photocopy of passport, charged nothing
Wrote another prescription for £5.50

In Ireland I am paying 3500 PRSI health levy per annum
I pay 2800 Private health insurance
Last year, our  receipts for prescriptions and GP was 2500

Banana republic


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## terrontress (1 Jul 2009)

CharlieC said:


> Banana republic


 
Independent socialist utopian republic.

Aren't we so better off than those people in Wales, NI and Scotland. Still occupied by the crown. Still having the NHS with its free GP visits, free or cheap prescriptions and a doctor who actually looks at you instead of getting a nurse to do it and justifying his €60 by sticking his head round the door and asking "everything OK here?".

Brave men fought and died to enable us to pay for those doctors' Mercedes.


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## Purple (1 Jul 2009)

Mrs Purple is a GP. She charges €50 a visit and €20 for a follow up. She is under pressure from other local GP's to increase her fees. Test results (if everything is OK) are given by phone for free. She still makes a very good living.


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## MrMan (1 Jul 2009)

terrontress said:


> Independent socialist utopian republic.
> 
> Aren't we so better off than those people in Wales, NI and Scotland. Still occupied by the crown. Still having the NHS with its free GP visits, free or cheap prescriptions and a doctor who actually looks at you instead of getting a nurse to do it and justifying his €60 by sticking his head round the door and asking "everything OK here?".
> 
> Brave men fought and died to enable us to pay for those doctors' Mercedes.


 
my doctor drives a skoda and I nearly have to convince him to take the money, €45. Collins & co need not turn in their graves.


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## burger1979 (1 Jul 2009)

Purple said:


> She is under pressure from other local GP's to increase her fees. .


 

 really purple???!!! are all the rest of the rates for the other gp's the same??? is your wife getting more custom since she has lower charges? €60 is alot for charging but if you take into account that the gp might have to pay for secratary, light and heat, office maintenance costs, nurse too maybe it can all add up. i havent been to a doctor in years and am only speaking from what i saw last time i was at one. they have 4 gp's with one nurse, 2 secrataries.


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## Firefly (1 Jul 2009)

Niallymac said:


> Price deflation is the only thing that can drive competitiveness


 
Competitiveness is the only thing that can drive price deflation

And that explains why prices are so high. If there were more GP places offered to qualified doctors prices would come down


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## Purple (1 Jul 2009)

Firefly said:


> If there were more GP places offered to qualified doctors prices would come down


That's the crux of it but they know that by limiting supply they can earn supernormal profits (remember your leaving cert economics?).


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## Purple (1 Jul 2009)

burger1979 said:


> really purple???!!! are all the rest of the rates for the other gp's the same???


Yes, they all went up within a few weeks and yes, she is very busy but because she's a great doctor who gives a great service (some of her patients travel over 40 miles to see her).
Now I am not saying that doctors engage in price fixing or anything, I’m sure it’s all a complete coincidence


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## Vanilla (1 Jul 2009)

We used to have a GP where we lived before and, honestly, half the time he would refuse to charge me, saying he wouldnt charge for 'babies', he was a dote and I used to give him a few bottles of wine every christmas and when we'd come back from france and so on. 

Since we've moved we go to a different GP and equally I find him really brilliant, honest and half the time he charges a smaller fee than he could. I know the time and training he has put in to become a GP ( as I have some in my immediate family) so I wouldnt begrudge him the full fee but he doesnt half the time. Full fee should be 50 but honestly, half the time he just asks for 30 or 25.  Also I've recommended him to loads of people because he is so nice and a really good GP. BTW his name is Dr. Michael Lynch and he practises in Killaloe, Co.Clare.


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## cerberos (1 Jul 2009)

Folks,

If you were paying cash - what % were on cards from from the SW?

C


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## annR (2 Jul 2009)

When my Dad retired as a GP, I used to have oul fellas I didn't even know coming up to me in the pub telling me how they only found out my Dad had been charging them half price for umpteen years when the new GP took over. . . . . . there are GPs out there charging a fair price.


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## terrontress (2 Jul 2009)

MrMan said:


> my doctor drives a skoda and I nearly have to convince him to take the money, €45. Collins & co need not turn in their graves.


 
Yeah, but in Scotland, with life under the crown, such a trip would cost nothing at point of use. And any prescriptions would not cost anything either.

It is not the GP's fault that people have to pay at point of use but it is a lousy system.


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## Purple (2 Jul 2009)

terrontress said:


> Yeah, but in Scotland, with life under the crown, such a trip would cost nothing at point of use. And any prescriptions would not cost anything either.
> 
> It is not the GP's fault that people have to pay at point of use but it is a lousy system.



How about no publically delivered primary (and very limited public delivery of hospital care) care but a national health insurance scheme (VHI, BUPA etc for those who can afford  it and state insurance for those who can’t)? Hey presto; no two tier health system and a reimbursement scheme that can be used to control costs to the exchequer. This system is used in Holland and Belgium (the country with the best healthcare system in Europe) amongst others.


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## terrontress (2 Jul 2009)

Purple said:


> How about no publically delivered primary (and very limited public delivery of hospital care) care but a national health insurance scheme (VHI, BUPA etc for those who can afford it and state insurance for those who can’t)? Hey presto; no two tier health system and a reimbursement scheme that can be used to control costs to the exchequer. This system is used in Holland and Belgium (the country with the best healthcare system in Europe) amongst others.


 
The difficulty is the "those who can afford it" element.

There should be a good standard of free at point of use healthcare for everyone, whether they be prince or pauper and the public should demand top class service. Should you wish, you can elect to pay for private medical insurance if sitting in a ward more akin to a hotel is your preference. But the standard of medical care offered should be no better.

There are many people I know in Ireland who are judged as "those who can afford it" and they stay away from GP surgeries when they have a health concern as they have better things to do with their €60. There is enough problem encouraging people who find a lump or blood in their stool to go to the doctor when the €60 is not a factor. Adding a €60 fine to the equation just makes people even less likely to seek help.

The notion of charging people for a GP visit is a disgrace. Charging in accident and emergency is even worse.


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## galleyslave (2 Jul 2009)

terrontress said:


> Independent socialist utopian republic.
> 
> Aren't we so better off than those people in Wales, NI and Scotland. Still occupied by the crown. Still having the NHS with its free GP visits, free or cheap prescriptions and a doctor who actually looks at you instead of getting a nurse to do it and justifying his €60 by sticking his head round the door and asking "everything OK here?".
> 
> Brave men fought and died to enable us to pay for those doctors' Mercedes.



try living in the UK. Income Tax, Council Tax (payable after income tax already taken), no mortgage relief. bin charges, car parking charges (outside yer own home no less in some places) water charges, bloody expensive commuting costs via public transport, etc etc... the cost of goods and services may be cheaper there, but you'll have less in your pocket to spend


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## Purple (2 Jul 2009)

terrontress said:


> The notion of charging people for a GP visit is a disgrace. Charging in accident and emergency is even worse.


 I disagree. When people get something for nothing (or nothing at the point of care) they are far more likely to abuse it. Mrs Purple has been called to houses in the middle of the night because parents have run out of Calpol for their child. In her experience medical card patients account for over 70% of out of hours house calls yet less than one third of people are medical card holders. The same goes for A&E; people go there with a ailment that has been ongoing for weeks. Anyone presenting with such a complaint should be sent to their GP and told to make an outpatient appointment. Don’t get me going about people who present to E&E drunk or drugged; they cost the state tens if not hundreds of millions a year as they clog up the whole hospital system. The state should recover all costs from these people, even if it leaves them penniless. 

Anyway, socialised medicine is very inefficient. Why create a bureaucracy to take taxes from people and then give the small proportion that is not squandered said bureaucracy back to them in the form of a socialised service delivery. At the end of the day the cost to the hospital/doctor is the same, why not cut out the bloated middleman and let people pay for it themselves through their insurance (or through insurance provided by the state)?
The argument about who can afford it themselves is no different to the one about who should pay what tax. If we were not paying for 5% of the workforce to be employed by the HSE then taxes should be lower.


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## terrontress (2 Jul 2009)

galleyslave said:


> try living in the UK. Income Tax, Council Tax (payable after income tax already taken), no mortgage relief. bin charges, car parking charges (outside yer own home no less in some places) water charges, bloody expensive commuting costs via public transport, etc etc... the cost of goods and services may be cheaper there, but you'll have less in your pocket to spend


 
Income tax is less than in Ireland.

Mortgage relief is on its way out here.

Bin tax is part of council tax. So are all the leisure centres, libraries, waste disposal centres and parks that are lacking here.

Parking enforcement in Dublin is every bit as draconian as it is in London.

Commuting is less expensive and more reliable in London than in Dublin.

I have friends in London who I visit regularly and I know all of this to be fact.


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## DeeFox (2 Jul 2009)

Purple said:


> I disagree. When people get something for nothing (or nothing at the point of care) they are far more likely to abuse it.


 
In my experience this is true.
A good friend of mine was let go from his job earlier in the year and he got his medical card last week.  Says he was in the doctors within hours of receiving it - no serious complaints but nothing that he would have gone to the doctor about if he'd had to pay for the privilege.


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## Towger (2 Jul 2009)

terrontress said:


> Income tax is less than in Ireland.
> 
> Mortgage relief is on its way out here.
> 
> ...




  You forgot that you can drop into your doctor in Ireland. I have relatives in London who in their local area have to make an appointment a week+ in advance!


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## terrontress (2 Jul 2009)

Purple said:


> I disagree. When people get something for nothing (or nothing at the point of care) they are far more likely to abuse it. Mrs Purple has been called to houses in the middle of the night because parents have run out of Calpol for their child. In her experience medical card patients account for over 70% of out of hours house calls yet less than one third of people are medical card holders. The same goes for A&E; people go there with a ailment that has been ongoing for weeks. Anyone presenting with such a complaint should be sent to their GP and told to make an outpatient appointment. Don’t get me going about people who present to E&E drunk or drugged; they cost the state tens if not hundreds of millions a year as they clog up the whole hospital system. The state should recover all costs from these people, even if it leaves them penniless.
> 
> Anyway, socialised medicine is very inefficient. Why create a bureaucracy to take taxes from people and then give the small proportion that is not squandered said bureaucracy back to them in the form of a socialised service delivery. At the end of the day the cost to the hospital/doctor is the same, why not cut out the bloated middleman and let people pay for it themselves through their insurance (or through insurance provided by the state)?
> The argument about who can afford it themselves is no different to the one about who should pay what tax. If we were not paying for 5% of the workforce to be employed by the HSE then taxes should be lower.


 
There is a mindset in Ireland stating that if you give people free healthcare they will abuse it. This is because what should be a basic human right has been turned in to a business.

I'd say if the breathing of fresh air had been regulated and charged for and that charge was subsequently abolished, you'd most likely find people trying to breathe more than their fair share!

Our current situation is uncivilised and really harms those people on the cusp of qualifying for a medical card.


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## terrontress (2 Jul 2009)

Towger said:


> You forgot that you can drop into your doctor in Ireland. I have relatives in London who in their local area have to make an appointment a week+ in advance!


 
My wife recently cut her finger but not too badly. I patched up in the evening and she went to the GP the next day.

At the GP, she was seen by a nurse who cleaned it and rebandaged it. The doctor poked his head round the door and asked "everything OK here?" to which the nurse replied affirmatively and the doctor headed off again.

That cost €60. 

It is no wonder the doctors don't have queues when they are pulling in such money for doing so little. I wouldn't turn anyone away if I was pulling in what they are.

Possibly the delay in appointments in London are due to the doctor taking time with each patient.


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## Purple (2 Jul 2009)

terrontress said:


> There is a mindset in Ireland stating that if you give people free healthcare they will abuse it.


 It's not a mindset, it's the reality on the ground. The same it true for anything you don't have to pay for/earn.



terrontress said:


> This is because what should be a basic human right has been turned in to a business.


 At what stage in the last 10'000 years was healthcare not a business? The problem is that it is not enough business competition, not that there is too much. Basic human rights are freedom and equality under the law and the right to retain a just proportion of the fruits of your labour. If you choose to sit on your ass while your neighbour works then there is no way in hell that he should have to foot the bill for your healthcare. 



terrontress said:


> I'd say if the breathing of fresh air had been regulated and charged for and that charge was subsequently abolished, you'd most likely find people trying to breathe more than their fair share!


 The production of air does not require human labour so the comparison is spurious. Drinking water would be a better analogy; if we had to pay for it more of us would turn off the tap when we brush our teeth and we would be more likely to collect rainwater to water our gardens. 


terrontress said:


> Our current situation is uncivilised and really harms those people on the cusp of qualifying for a medical card.


 What harms people most is working their asses off while their neighbour on welfare enjoys the same standard of living because those who work pay so much tax.


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## Purple (2 Jul 2009)

terrontress said:


> My wife recently cut her finger but not too badly. I patched up in the evening and she went to the GP the next day.
> 
> At the GP, she was seen by a nurse who cleaned it and rebandaged it. The doctor poked his head round the door and asked "everything OK here?" to which the nurse replied affirmatively and the doctor headed off again.
> 
> ...


 Go to a doctor that charges less or ask why you are being charged so much when you only saw the nurse. The problem in this case in lack of backbone, not lack of socilaised medicine.



terrontress said:


> Possibly the delay in appointments in London are due to the doctor taking time with each patient.


 No, it's because a vast state bureaucracy it trying to run what should be an open market of small businesses.


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## galleyslave (2 Jul 2009)

terrontress said:


> Income tax is less than in Ireland.


really? 
http://www.hmrc.gov.uk/rates/it.htm
http://www.citizensinformation.ie/c...x/income-tax/how_your_tax_is_calculated#rules



terrontress said:


> Mortgage relief is on its way out here.


but not yet gone and still a long way to go...



terrontress said:


> Bin tax is part of council tax. So are all the leisure centres, libraries, waste disposal centres and parks that are lacking here.


they're looking to bring in bin charges... my mistake on that one.. as for the rest, we do have then here you know.. been to my local library frequently... it's a fact *g*



terrontress said:


> Parking enforcement in Dublin is every bit as draconian as it is in London.


not enforcement, charges... my local council in london wanted money from me so I could park outside my own house for example. 



terrontress said:


> Commuting is less expensive and more reliable in London than in Dublin.


having lived in both cities, I don't agree..



terrontress said:


> I have friends in London who I visit regularly and I know all of this to be fact.


having lived in both cities I disagree...

I moved back to Ireland as it offered a better standard of living and more money in my pocket.


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## terrontress (7 Jul 2009)

galleyslave said:


> really?
> http://www.hmrc.gov.uk/rates/it.htm
> http://www.citizensinformation.ie/c...x/income-tax/how_your_tax_is_calculated#rules
> 
> ...


 
The income tax links you provided seem to support what I have said and don't take income levy into account.

Do you know how much it costs to get a weekly ticket from Donabate to Sandyford combining train and Luas? About €36. Which allows you to travel from Rush & Lusk as far as Blackrock and three zones on the Luas. About 25 miles in total. How much is a weekly travelcard in London for two zones and how many miles on tube, overland and bus does that let you travel.

There is no bin tax in UK so your argument doesn't stand.

Mortgage relief has been severely diminished in Ireland, you can't deny it. In any case, it was described as a "middle class perk" by Gordon Brown when he abolished it in the UK and I tend to agree with him.

When I lived in Portobello, Dublin City Council wanted money off me to park outside my own front door. That was in 2002 - 2004. It may have changed since then but I am not sure.

Taxation in London is comparable, if not better, to Ireland in most regards and yet they don't have to pay €60 to go to the doctor, €80 to go to A&E and pay through the nose to get a fire engine or ambulance in a real emergency.

Tinpot banana republic.


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## galleyslave (7 Jul 2009)

terrontress said:


> The income tax links you provided seem to support what I have said and don't take income levy into account.


do the figures...



terrontress said:


> Do you know how much it costs to get a weekly ticket from Donabate to Sandyford combining train and Luas? About €36. Which allows you to travel from Rush & Lusk as far as Blackrock and three zones on the Luas. About 25 miles in total. How much is a weekly travelcard in London for two zones and how many miles on tube, overland and bus does that let you travel.


2 zones is hardly a fair comparison to travelling from lusk to presumably the city centre. 
this links provides a better idea of the costs
http://www.londontoolkit.com/briefing/travelcard.htm



terrontress said:


> Mortgage relief has been severely diminished in Ireland, you can't deny it. In any case, it was described as a "middle class perk" by Gordon Brown when he abolished it in the UK and I tend to agree with him.


your political views are irrelevant. It still exists and is a benefit to anyone with a mortgage, regardless of social class. 



terrontress said:


> Taxation in London is comparable, if not better, to Ireland in most regards and yet they don't have to pay €60 to go to the doctor, €80 to go to A&E and pay through the nose to get a fire engine or ambulance in a real emergency.
> 
> Tinpot banana republic.


Rubbish - so we pay for doctors and A&E - so what... by that logic the USA is a tinpot republic also... and to say taxation in london is better than here is plain wrong. try applying uk tax rates (and include community tax) to your irish pay packet and see where  you get


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## roker (7 Jul 2009)

If the doctor is part of a health centre, the charge is standard, what annoys me, is if the treatment does not work, they charge another €60 to try again with another treatment, it may take about 3 visits before they refer you to a consultant, and the charges start again.


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## terrontress (7 Jul 2009)

galleyslave said:


> do the figures...
> 
> 
> 2 zones is hardly a fair comparison to travelling from lusk to presumably the city centre.
> ...


 
The Republic of Ireland was recently founded on the supposed basis of a socialist republic of equals. And two wrongs do not make a right. Take a simple google search and see how Irish healthcare compares to the rest of Europe. And nobody is holding up the USA model as a utopian system.

Mortgage relief is no longer a benefit to anyone with a mortgage in Ireland.

What about the rate of VAT in Ireland compared to what you pay in the UK?

Duty on alcohol? Less in the UK.

Stamp duty on housing? Less in the UK. 

Stamp duty on credit and debit cards? NONE in the UK.

What about the tolling of standard infrastructure in Ireland which does not exist in the UK?

What about VRT which does not exist in the UK?

Listen, we are being ridden every which way by people feathering their own nests and cannot even hope to fall back on the state should we become ill.

I can put up with stamp duties, road tolls, VRT and all other things which are either more in Ireland or unique to Ireland. But we should all have the right to a free healthcare system which is free at the point of use or we are nothing more than a nation of savages who would gladly step on the head of our neighbour to clamber out of deep water.


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## Purple (7 Jul 2009)

terrontress said:


> The Republic of Ireland was recently founded on the supposed basis of a socialist republic of equals.


 Eh??? Where does it say we are socialist in the Constitution? 



terrontress said:


> and cannot even hope to fall back on the state should we become ill.


 Yes we can; everyone can avail of our heath care system, if you can’t pay it’s free.



terrontress said:


> But we should all have the right to a free healthcare system which is free at the point of use or we are nothing more than a nation of savages who would gladly step on the head of our neighbour to clamber out of deep water.


 What a load of rubbish. Holland, Germany etc have national insurance schemes. A free at the point of use system is wasteful and so those that really need help are less likely to get it. 
Socialism doesn’t work; the last guys trying it live in North Korea and it ‘aint working out too well for them at the moment.  
Now how about getting back on topic; the solution if you think your GP is overcharging it to query the charge and change doctor if you are not happy (it is a free market after all).


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## galleyslave (7 Jul 2009)

terrontress said:


> The Republic of Ireland was recently founded on the supposed basis of a socialist republic of equals. And two wrongs do not make a right. Take a simple google search and see how Irish healthcare compares to the rest of Europe. And nobody is holding up the USA model as a utopian system.


dear divine jaysus, give over with the leftie retoric. We're no more socialist than the pope's a hippy and thank god for that. 



terrontress said:


> Mortgage relief is no longer a benefit to anyone with a mortgage in Ireland.


baloney. it's a benefit to me, and it's a benefit to many others. its money directly in my pocket every month. 




terrontress said:


> What about the rate of VAT in Ireland compared to what you pay in the UK?


what about it, we're not talking about VAT



terrontress said:


> Duty on alcohol? Less in the UK.


much as i'd like it reduced, it's hard to argue against taxing unhealthy vices like fags and booze. 



terrontress said:


> Stamp duty on housing? Less in the UK.


agreed



terrontress said:


> Stamp duty on credit and debit cards? NONE in the UK.


small change



terrontress said:


> What about the tolling of standard infrastructure in Ireland which does not exist in the UK?


ever driven up the m6 motorway?



terrontress said:


> What about VRT which does not exist in the UK?


what about it- unfair I agree...



terrontress said:


> Listen, we are being ridden every which way by people feathering their own nests and cannot even hope to fall back on the state should we become ill.


actually, we can


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## galleyslave (7 Jul 2009)

re tax

try this
http://www.deloitte.ie/tc/Default.aspx
http://listentotaxman.com/

put in 30 grand sterling and say 33000 irish and see the results
and then factor in a good 100 a month in the compulsory council tax


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## CharlieC (7 Jul 2009)

galleyslave said:


> re tax
> 
> try this
> http://www.deloitte.ie/tc/Default.aspx
> ...


 
Try putting in 50k stg and 55k Euro you start hitting nearer the mark about the same 29% in deductions. You see we have a narrower tax base.


Back on topic in Dublin there are no ear doctors on duty in the Eye and Ear Hospital A&E at the weekend.
Gombeen land


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## terrontress (8 Jul 2009)

galleyslave said:


> re tax
> 
> try this
> http://www.deloitte.ie/tc/Default.aspx
> ...


 
Smoke and mirrors on your part.

You keep adding arbitrary elements to this thread and when they are challenged you keep shifting point.

The issue is that people in the UK are taxed less and have better public services.

And we have the second worst healthcare system in Europe (source http://www.rte.ie/news/2006/0626/health1.html)

And to top it off, it is not free at point of usage which leads people just above the medical card to ignore health concerns as they have better things to spend €60 on and do not have the confidence to go into a doctor's surgery and haggle with him.


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## galleyslave (8 Jul 2009)

terrontress said:


> Smoke and mirrors on your part.
> 
> You keep adding arbitrary elements to this thread and when they are challenged you keep shifting point.
> 
> The issue is that people in the UK are taxed less and have better public services.


no, the issue I disagreed with was that people in the uk are so much better off than us. I disagree. On an average salary it's clear from the calculators that somebody in Ireland has more disposable income than somebody in the UK, and thats without even factoring in community tax. Yes, we pay more for goods and services, but at least we have the cash in our pocket to do so, and indeed, a choice as to whether we do so or not.



terrontress said:


> And we have the second worst healthcare system in Europe (source http://www.rte.ie/news/2006/0626/health1.html)
> 
> And to top it off, it is not free at point of usage which leads people just above the medical card to ignore health concerns as they have better things to spend €60 on and do not have the confidence to go into a doctor's surgery and haggle with him.


as to ignoring health concerns, I think the real issue is the strain on A&E from people using it in lieu of a visit to the doctor. 

Also, the NHS is hardly a panacea, yes, there are some nice freebies, but ultimately it's paid for through higher taxation and also, look at the lottery that is nhs cancer treatment - hardly a vision of equality now, is it?


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## Purple (8 Jul 2009)

Britain is one of the major financial centres in the world. They are a former empire with massive overseas economic interests. They are a major trading centre, have oil, gas and coal reserves and still have, in comparison to us, a massive manufacturing base backed up by some of the best universities in the world. 
Ireland is a small peripheral island off the coast of Europe with little indigenous industry, no overseas interests, no natural resources that we control, a second rate university system and an economy about the same size of Manchester. 

The idea that we could have the same level of services for the same (approximate tax rates) as the UK is laughable especially considering that we pay the people delivering those services so much more. Now this whole conversation is nonsensical so can we get back on topic before someone starts comparing us to one of the small but fully developed countries on the mainland like Belgium or Denmark?


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## CharlieC (8 Jul 2009)

In belgium you can walk in off the street to see any kind of specialist
You get most of this reimbursed via your state contributions, although they did have the Congo.

I have been sick in a lot of countries


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## Purple (8 Jul 2009)

CharlieC said:


> In belgium you can walk in off the street to see any kind of specialist. You get most of this reimbursed via your state contributions,


Yep, the best healthcare system in Europe. It is almost completely privately delivered and funded through health insurance (if you can’t pay for it yourself the government does) with a reimbursement scheme to keep standards up and costs down. Just what we need here rather than 1950’s style collectivist socialism.


CharlieC said:


> although they did have the Congo.


 Well if the cost of having a good healthcare system is enslaving a nation the size of Western Europe and killing over a million people then I’d stick with what we have. (Read _King Leopold’s Ghost_ for details)


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## peelaaa (8 Jul 2009)

galleyslave said:


> really?
> http://www.hmrc.gov.uk/rates/it.htm
> http://www.citizensinformation.ie/c...x/income-tax/how_your_tax_is_calculated#rules
> 
> ...


 
London is not Great Britain as Dublin is not Republic of ireland yet it is still 60 euros no matter where you live in Ireland. In Great Britain, outside of London, living costs are a lot lower.


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## galleyslave (8 Jul 2009)

peelaaa said:


> London is not Great Britain as Dublin is not Republic of ireland yet it is still 60 euros no matter where you live in Ireland. In Great Britain, outside of London, living costs are a lot lower.


and so are wages...


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## peelaaa (8 Jul 2009)

galleyslave said:


> and so are wages...


I have lived in london, other parts of uk and dublin, money doesn't go as far here have to say. Especially when paying out doctors bills for family.


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## galleyslave (8 Jul 2009)

peelaaa said:


> I have lived in london, other parts of uk and dublin, money doesn't go as far here have to say. Especially when paying out doctors bills for family.


we have more disposable income here, but pay more for goods and services. it pretty much balances out, but does require greater responsibility by people. in the uk, labour takes more of our cash up front and gives us more for 'free' thus reducing the levels of personal responsibility. Swings and roundabouts... 

It would be far more productive to ensure we shop around to avoid being ripped off than to complain about our taxation system, although I agreed, doing so with doctors is not so easy. seems like a cosy cartel if they all charge the same


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## DublinTexas (8 Jul 2009)

In Ireland I pay a 4% health levy plus 8% PRSI and get the 2nd worst healthcare in Europe in which I also have to pay my GP over 50€  and if I don’t want to die on a trolley a private health insurance which also has a government levy on it.
In France I pay a 0.75 % health insurance contribution next to a 7.5% social security tax and get one of the world’s best healthcare and after the insurance gives me 70% of my GP fee back, I only pay 6.60 € for it. And if I don’t like the 70% rule than I can pay up to 2.5% of my salary for 100% refund.
In 2006 Ireland used 8.2 % of GDP or US$3,996 per capita on healthcare to deliver a bad service, at the same time in France used 11.2% of GDP on health care, or US$3,926 per capita.
Yes less per capita but better service!
So I don’t need an NHS , I gladly take the French system, if I can’t get the Belgium system.


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## Purple (8 Jul 2009)

DublinTexas said:


> In Ireland I pay a 4% health levy plus 8% PRSI and get the 2nd worst healthcare in Europe in which I also have to pay my GP over 50€  and if I don’t want to die on a trolley a private health insurance which also has a government levy on it.
> In France I pay a 0.75 % health insurance contribution next to a 7.5% social security tax and get one of the world’s best healthcare and after the insurance gives me 70% of my GP fee back, I only pay 6.60 € for it. And if I don’t like the 70% rule than I can pay up to 2.5% of my salary for 100% refund.
> In 2006 Ireland used 8.2 % of GDP or US$3,996 per capita on healthcare to deliver a bad service, at the same time in France used 11.2% of GDP on health care, or US$3,926 per capita.
> Yes less per capita but better service!
> So I don’t need an NHS , I gladly take the French system, if I can’t get the Belgium system.


 Excellent post!


It exposes the lies propagated by the charlatan in the healthcare industry, be they nurses, doctors or “managers” who claim that under funding is the problem (remember that we have a much younger population than France so we should be spending even less).


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## bogle (8 Jul 2009)

Purple said:


> Excellent post!
> 
> 
> It exposes the lies propagated by the charlatan in the healthcare industry, be they nurses, doctors or “managers” who claim that under funding is the problem (remember that we have a much younger population than France so we should be spending even less).



Yes all well and good, but when you've got professionals working in the health care system who think a guaranteed €200+ K  a year to be paid from the public purse is mickey mouse money.......!!!

By the way I think you're idea of haggling with a GP is ridiculous! I had cause to visit the GP last summer. There were mumblings of surgical biopsies needed and so on --> the last thing I was going to do was start haggling with him over €5!


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## Purple (8 Jul 2009)

bogle said:


> Yes all well and good, but when you've got professionals working in the health care system who think a guaranteed €200+ K  a year to be paid from the public purse is mickey mouse money.......!!!


I agree; they are part of the problem; over paid, unwilling to change and way too far up their own posteriors.



bogle said:


> By the way I think you're idea of haggling with a GP is ridiculous! I had cause to visit the GP last summer. There were mumblings of surgical biopsies needed and so on --> the last thing I was going to do was start haggling with him over €5!


 Did you ask what the price was before you bought the service? If not and you paid (and returned) then stop crying about forking out for it. If you think you are overcharged then find a cheaper GP (prices in Dublin vary from €40 to €75 per visit.


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## bogle (8 Jul 2009)

Purple said:


> ... bought the service? If not and you paid (and returned) then stop crying about forking out for it. If you think you are overcharged then find a cheaper GP (prices in Dublin vary from €40 to €75 per visit.



Following you're logic then. Someone discovers a lump where they shouldn't have one. You're advice in these hard times is to starting ringing around GPs asking how much they'll charge for a consultation, maybe do a bit of haggling over the price with the receptionist (offer to wait two weeks for the appointment if she'll knock 10% off), and then pick the one where you think you've got the best value, instead of going to the person who has all your records on file for the last umpteen years. 

Priceless!


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## Purple (8 Jul 2009)

bogle said:


> Following you're logic then. Someone discovers a lump where they shouldn't have one. You're advice in these hard times is to starting ringing around GPs asking how much they'll charge for a consultation, maybe do a bit of haggling over the price with the receptionist (offer to wait two weeks for the appointment if she'll knock 10% off), and then pick the one where you think you've got the best value, instead of going to the person who has all your records on file for the last umpteen years.
> 
> Priceless!



How about finding a GP who you are happy with, staying with them and not crying about the fee they charge. If you think you are not getting good value for money then find a different GP that offers better value for money, go and see them and if you are happy with them have your file transferred. There's no need for any hysterical scenarios when lumps are found or your legs turn green etc.
The main thing is to remember that you are the customer, yes; you are buying a service. The GP is not doing you a favour by seeing you, you are doing them a favour by buying medical services from them. You are not obliged to keep buying your primary healthcare from a GP with whom you are not happy, it may come as a surprise to you but you can move GP's and they are obliged to forward your file at no charge (since it is your file).

Now that I have explained the same thing again I hope you understand. By the way the same applies to solicitors, accountants, window cleaners, mechanics, painters, bottle-washers, flower-arrangers, shoe shops, newsagents, super markets etc.
I would suggest that you don't change accountant the day you find our you are about to be audited by Revenue just as you shouldn't change GP's the day you find a lump... but that's just stating the bleedin' obvious, isn't it?


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## Firefly (9 Jul 2009)

From what I hear though, many GPs (and dentists) are "full" and not taking on new patients. Maybe this was when I was in Dublin and does not apply elsewhere..so it's hard to shop around


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## Purple (9 Jul 2009)

Firefly said:


> From what I hear though, many GPs (and dentists) are "full" and not taking on new patients. Maybe this was when I was in Dublin and does not apply elsewhere..so it's hard to shop around


 Many of the ones with GMS lists won't take any more GMS patients but most newer GP's don't have GMS lists as it's a bit of a closed shop.


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## galleyslave (9 Jul 2009)

Firefly said:


> From what I hear though, many GPs (and dentists) are "full" and not taking on new patients. Maybe this was when I was in Dublin and does not apply elsewhere..so it's hard to shop around


sounds just like the uk


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## BoscoTalking (9 Jul 2009)

Purple said:


> The GP is not doing you a favour by seeing you, you are doing them a favour by buying medical services from them. You are not obliged to keep buying your primary healthcare from a GP with whom you are not happy,


You do have to buy a service from a gp though prior to being referred further and there appears to be no supply and demand or varying charges between GP's as far as i have experienced. Thats the main issue. 

I moved house and rang a lot of GP's for prices/hours/specialties and no matter the response all had roughly the same price - 55e+ per consultation. Some charged for blood draws, didn't give results over the phone (so you got charged on the double), etc
Contrastingly when i bought the house i rang solicitors and got prices varying from 999+vat to 3k+vat for the same service. It seems to me that in some places price fixing could be suspected for GP's


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## Purple (9 Jul 2009)

pennypitstop said:


> It seems to me that in some places price fixing could be suspected for GP's



I would agree. 
Did you find one that you were happy with (service wise)?
The added costs (blood results over the phone or not etc, reduced charge for return visit etc) are what you should look out for.


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## Caveat (9 Jul 2009)

Firefly said:


> From what I hear though, many GPs (and dentists) are "full" and not taking on new patients. Maybe this was when I was in Dublin and does not apply elsewhere..so it's hard to shop around


 
True in the NE too.

I know of 4 or 5 GPs that aren't taking on new patients - I'm sure there are more.  

A couple of poles have told me that they found it very difficult to get a GP who was willing to take them on - they found a couple eventually, but it wasn't easy.  They didn't even investigate dentists though as it's much cheaper in Poland and Irish dentists seem to have a poor reputation - with poles at least.


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## DublinTexas (10 Jul 2009)

There is actually a chain of GP’s these days which give you a loyalty card, which gives you 20% discount on GP Consultants so that the price is only 40€. And it’s a follow up they only charge a smaller fee.

These sit in Medical & Dental Centre’s around Dublin and are providing what works in other countries well, a primary health care centre.

So fact is, it is also possible to do it differently for a smaller fee when there is competition.


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## Raskolnikov (10 Jul 2009)

I was referred to a specialist by my GP in a private clinic. Specialist took a look at the problem, recommended an MRI and then passed me onto another specialist because he couldn't deal with the problem.

€180 for the privilege of a five minute consultation, only for him to pass the buck.

No one begrudges a good doctor their fee, but the medical profession need to get realistic and stop holding us over a barrel.


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## liaconn (10 Jul 2009)

I've had to attend a consultant a couple of times recently. The receptionist barely says 'hello' to you before she asks you for the fee. I find this really annoying. I can understand that invoicing patients may lead to delays and non payment of fees. But surely they could let you pay on the way out, not have their hand held out the minute you walk in the door.


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## Purple (10 Jul 2009)

Raskolnikov said:


> €180 for the privilege of a five minute consultation, only for him to pass the buck.


Yep, it’s like if brought your car to a mechanic, he opened the bonnet, said “sorry, I can’t fix that. Go down the road to Mick” and then charged you anyway. 

Some would argue that you pay for the knowledge of a lifetime etc but if that knowledge is bugger all use then it’s of bugger all value in that instance.


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## truthseeker (10 Jul 2009)

liaconn said:


> I've had to attend a consultant a couple of times recently. The receptionist barely says 'hello' to you before she asks you for the fee. I find this really annoying. I can understand that invoicing patients may lead to delays and non payment of fees. But surely they could let you pay on the way out, not have their hand held out the minute you walk in the door.


 
Worse, yesterday my OH saw a consultant in a well known private clinic. His appointment time was 9.30, when he arrived at 8.45 the receptionist asked for the payment, he tried to pay with a credit card, she said they dont take credit cards, he tried to pay with laser, they dont take laser, she asked him to go get the cash, he had to take his car out of the carpark (and thus pay a second parking fee) and go off to the nearest shopping centre (no banklink in the clinic itself) and come back with cash - and all this prior to 9.30. Despite being registered on the 'list' by the receptionist at 8.45 he was not in fact seen until 10.45 - no apology.

Plus, despite being a patient of this particular consultant, because he hadnt seen him in 2 years he was back to the new patient fee of 200 euro, as opposed to the existing patient fee of 160.

Its a total racket.


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## liaconn (10 Jul 2009)

truthseeker said:


> Worse, yesterday my OH saw a consultant in a well known private clinic. His appointment time was 9.30, when he arrived at 8.45 the receptionist asked for the payment, he tried to pay with a credit card, she said they dont take credit cards, he tried to pay with laser, they dont take laser, she asked him to go get the cash, he had to take his car out of the carpark (and thus pay a second parking fee) and go off to the nearest shopping centre (no banklink in the clinic itself) and come back with cash - and all this prior to 9.30. Despite being registered on the 'list' by the receptionist at 8.45 he was not in fact seen until 10.45 - no apology.
> 
> Plus, despite being a patient of this particular consultant, because he hadnt seen him in 2 years he was back to the new patient fee of 200 euro, as opposed to the existing patient fee of 160.
> 
> Its a total racket.


 
I hope he's going to complain. That is disgraceful treatment! Also, I would name and shame the clinic.


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## Purple (10 Jul 2009)

liaconn said:


> I hope he's going to complain. That is disgraceful treatment!


 Standard behaviour with many of those bozos unfortunately.



liaconn said:


> Also, I would name and shame the clinic.



So would I, if this was my website... but it's not so I wouldn't.


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## truthseeker (10 Jul 2009)

liaconn said:


> I hope he's going to complain. That is disgraceful treatment! Also, I would name and shame the clinic.


 
Its pretty bad alright, Ive experienced same in the same place (although I seem to remember I was allowed to phone the secretary in his rooms elsewhere to make a credit card payment over the phone), but the days of your appointment time being your appointment time in this place are long gone.

Think of a well known private clinic - its probably the one you are thinking of, its extremely well known.


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## Raskolnikov (10 Jul 2009)

Well it ain't the Blackrock Clinic, where you can hardly move for all the POS terminals!


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## Raskolnikov (10 Jul 2009)

truthseeker said:


> (and thus pay a second parking fee)


The fact that you had to pay for parking, in a private clinic and all, is ridiculous.


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## Caveat (10 Jul 2009)

truthseeker said:


> Plus, despite being a patient of this particular consultant, *because he* *hadnt seen him in 2 years he was back to the* *new patient fee* of 200 euro, as opposed to the existing patient fee of 160.


 


New patient fee - WTF?!


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## truthseeker (10 Jul 2009)

Caveat said:


> New patient fee - WTF?!


 
Didnt you know? The first time you see a consultant is more expensive than subsequent visits as you are a new patient first time around. This apparently applies after 2 years have elapsed also.


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## galleyslave (10 Jul 2009)

truthseeker said:


> Didnt you know? The first time you see a consultant is more expensive than subsequent visits as you are a new patient first time around. This apparently applies after 2 years have elapsed also.



went to the doctors here in cork and that wasn't the case


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## truthseeker (10 Jul 2009)

galleyslave said:


> went to the doctors here in cork and that wasn't the case


 
No it doesnt happen with all of them.

I saw an orthopediac consultant in a sport injury type place and it was 150, first time and subsequent times. But he had no secretary or 'rooms' there, just sat there once a week and saw patients.

Then again Ive had the 200 quid first time visit and 160 after happen in both Blackrock clinic and Charlemont clinic with different consultants.

I wonder do the consultants themselves set the fees? I do not find it very impressive to pay that much money for a 5 minute consultation where he asks if the medicine is working and just prescribes more of same and tells you to come back in 6 months.


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## Caveat (10 Jul 2009)

truthseeker said:


> Didnt you know? The first time you see a consultant is more expensive than subsequent visits as you are a new patient first time around. This apparently applies after 2 years have elapsed also.


 
No wonder they ask for payment in advance - people probably wouldn't pay otherwise!  I certainly wouldn't pay an extra €40 just because they hadn't seen me in 2 years.


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## truthseeker (10 Jul 2009)

Caveat said:


> No wonder they ask for payment in advance - people probably wouldn't pay otherwise! I certainly wouldn't pay an extra €40 just because they hadn't seen me in 2 years.


 
Whats the alternative though? The consultant has all his records, has dealt with this particular issue with him before etc... and he did not have to see a GP and pay 60 euro to get a referral to the consultant as he has seen him before.

If he resfused to pay the extra 40 and the consultant refused to see him, he would end up having to pay the GP 60 euro to get a referral to someone else then pay the new patient fee with someone else!! So it would end up costing 260 euro plus the hassle of sending for the records etc....

They have you caught between a rock and a hard place IMO. There seems to be little or no negotation power, especially with the protective circle of GP referrals needed for consultants.


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## Caveat (10 Jul 2009)

I agree - and that's what I'm saying. If you paid _after_ the visit like with most (practically all?) GPs and were advised "oh this extra €X is because we haven't seen you in 2 years" people simply wouldn't pay it. 

Seriously, I'm sure all these loadings/extras are why payment in advance is required - why else? Its isn't usual in most other medical or professional services.


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## liaconn (10 Jul 2009)

Raskolnikov said:


> Well it ain't the Blackrock Clinic, where you can hardly move for all the POS terminals!


 
An it can't be the Mater, because there's no shopping centre close by. That only leaves two that I can think of.


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## annet (10 Jul 2009)

Not all consultants are money grabbing sods!  After a two year break - did the consultant not remember that you are not a first time patient... if it is the same problem that you are attending them for... begs the question?


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## colin79ie (10 Jul 2009)

Brought a sick child to the GP. I knew an antibiotic was going to be needed due to a chest infection. (A bit of medical knowledge!)

Was told that no antibiotic was needed and the child was ok. I was charged €40. I told the doctor that WHEN I bring the child back in after he gets worse, I will not be paying him.

So, the next day I brought the child back in. He is so busy he obviously didn't kop it but immediately said he needed an antibiotic and wrote out the prescription. I then told him about my previous visit and that I wouldn't be paying him. He said I HAD to pay. I told him I wasn't and walked out without paying him. I have been back since for another reason and he apologised.

 Blood pressure, heart rate, temperature, reflexes. Anything more serious than a flu is referred. Easy money.

Answereable to no one.


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## Complainer (11 Jul 2009)

Raskolnikov said:


> I was referred to a specialist by my GP in a private clinic. Specialist took a look at the problem, recommended an MRI and then passed me onto another specialist because he couldn't deal with the problem.
> 
> €180 for the privilege of a five minute consultation, only for him to pass the buck.


Make sure you let your GP know what happens, so that he doesn't continue to mess around his other patients in this way.


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## liaconn (11 Jul 2009)

colin79ie said:


> Brought a sick child to the GP. I knew an antibiotic was going to be needed due to a chest infection. (A bit of medical knowledge!)
> 
> Was told that no antibiotic was needed and the child was ok. I was charged €40. I told the doctor that WHEN I bring the child back in after he gets worse, I will not be paying him.
> 
> ...


 

I think I would be changing my doctor.


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## truthseeker (12 Jul 2009)

annet said:


> Not all consultants are money grabbing sods!  After a two year break - did the consultant not remember that you are not a first time patient... if it is the same problem that you are attending them for... begs the question?



Consultant in question has been treating this particular issue in my OH for over 10 years now on and off (without getting too detailed, its a minor issue, more cosmetic than anything). Its not a case of not remembering, after a 2 year gap the charge is automatically reverted back to new patient charge for first consultation.


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## liaconn (12 Jul 2009)

How on earth can they justify this? That's pure greed. I assumed the reason for the initially higher charge was because the Consultant had to spend a certain amount of time asking questions in order to familiarise him/herself with your medical history,while subsequent visits tended to be much shorter.


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## annet (12 Jul 2009)

truthseeker said:


> Consultant in question has been treating this particular issue in my OH for over 10 years now on and off (without getting too detailed, its a minor issue, more cosmetic than anything). Its not a case of not remembering, after a 2 year gap the charge is automatically reverted back to new patient charge for first consultation.


 
Unbelievable.... but I have to say the private health insurers have their role in this sorry mess thats Ireland's health service.  I use to see it where patients would be admitted to hospital by consultants purely for investigations - that could very well have been done as an outpatient - but because of the charge that patients they were admitted as in-patients.... imagine the actual costs of an inpatient admission.  Then scenarios would frequently arise where one consultant would refer to another consultant and you'd be wondering for what reason - and again they'd be getting a nice little fee.  When they werent on the golf course they'd be popping their head around the door in the early morning just to say hi - and charging for the pleasure.

On another issue, I also reading in the Irish Medical News (June 29, 2009) the nice earner to the tune of €34 million that Ireland's GP's receive from the Department of Social Welfare for filling in their patients weekly illness benefit forms for their patients.  An increase was apparently given in this summer where a GP now gets €8.25 per certificate and €44.44 per medical report when people are called before the medical referees in the Department?


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## Purple (13 Jul 2009)

Good post Annet. Add to that the extra days spent in hospital because the consultant doesn't bother to come in and discharge their patients.


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## roker (13 Jul 2009)

A few years ago I had a check up with a consultant and he sent me for an ultrasound scan; I paid him for the visit. I then had to return for another visit, I was less than 2 minutes, I did not even have time to sit downall, all he he said was everything was Ok, and tried to charge me another visit for which I refused. He could have told me over the phone and saved me time off work.


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## liaconn (13 Jul 2009)

Fair play to you. What kind of reaction did you get when you refused to pay?


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## roker (13 Jul 2009)

He kept sending bills untill I told him we would take it to the hospital board.
I told him that he was €x amount per hour and that he will soon be on more than M Jackson.


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## Complainer (23 Jul 2009)

Just came across this directory listing website for GP surgeries and other health clinics . Unfortunately, it looks like most GPs are listed as 'price on application', though my own GP has kindly listed his standard consultation price.


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## sunrock (23 Jul 2009)

In the u.k. where doctor visits are free,one has to have an appointment and the waitng room is full.
In ireland those who have to pay their 60e will think twice about going to their G.P.
Those on medical cards visit their doctors much more often.
If those on medical cards had to pay something like 5e to visit their doctor..it would make a lot more sense.


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## smiley (23 Jul 2009)

sunrock said:


> Those on medical cards visit their doctors much more often.
> If those on medical cards had to pay something like 5e to visit their doctor..it would make a lot more sense.



Yes a small charge is an excellent idea for gp visits and prescriptions.

My own chemist told me last week that there is terrible waste. A lot of people with medical cards will often get things on prescription that they don't need at all. She said a small charge for each item..say 50c would stop a lot of this. The fact that people have to pay something will stop most from asking for it, and saving the state a fortune.


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## franmac (23 Jul 2009)

sunrock said:


> In the u.k. where doctor visits are free,one has to have an appointment and the waitng room is full.
> In ireland those who have to pay their 60e will think twice about going to their G.P.
> Those on medical cards visit their doctors much more often.
> If those on medical cards had to pay something like 5e to visit their doctor..it would make a lot more sense.



I have a medical card and I certainly do not abuse it. I visit my doctor quarterly to have blood pressure etc checked and prescription renewed.

Other than that unless other problems arise and thankfully they are few and far between I don't visit because I have better things to do than sit for hours in a doctors waiting room.


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## sunrock (24 Jul 2009)

The problem is a lot of the medical card people use their doctor for very small concerns such as colds or ordinary headaches or just a bit of reassurance.Their doctor is typically very sympathetic and consoling and they meet friends in the waiting room and they don`t have a lot else to do.
My point is a small charge ..even 1 or 2 euros would remind them that they are in a buisness relationship with their doctor and that they would reduce the amount of doctors visits .


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## Complainer (24 Jul 2009)

sunrock said:


> The problem is a lot of the medical card people use their doctor for very small concerns such as colds or ordinary headaches or just a bit of reassurance.Their doctor is typically very sympathetic and consoling and they meet friends in the waiting room and they don`t have a lot else to do.
> My point is a small charge ..even 1 or 2 euros would remind them that they are in a buisness relationship with their doctor and that they would reduce the amount of doctors visits .


I heard a Professor of Pharmacy on the radio during the week presenting the hard research showing that 'small charges' in relation to prescription drugs result in a significant number of people NOT getting the medication that they need.


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