# TV Participants Wanted: What Are Your Thoughts On GP Fees?



## cocotv (6 Oct 2009)

Hi Martin here from Coco Television

We’re working on a new consumer show and we’d like to hear from people who have comments to make on GP charges

Do you feel your GP charges are good value for money? 

Do you feel there is a clear pricing structure in place? 

How do you feel about being charged for extras such as blood tests or repeat prescriptions? 

We’re looking for people to be in the audience of the show who might like to make a comment and if you can’t make it we still want to hear your views

_Please contact me on 01) 4970817 or email me your comment to martin@cocotelevision.ie 
_


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## keithkarl200 (6 Oct 2009)

I have a recurring health condition, for the past 2-3 years i don't know how many times i have been into my GP. Recently I have been in there 3 times for this problem. I am a qualified cabinet maker and get around €13 an hour. My GP  gets €50 for my 5 minute visit and 1 hour wait in the waiting room


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## roker (6 Oct 2009)

It annoys me when a GP makes a diagnosis and the treatment does not work. Why should he charge the next time you visit to try some other treatment? He can keep you returning indefinitely. If he cannot treat the complaint he will eventually send you to a consultant but you have already paid him for a number of visits (for zero result) and may have to pay the consultant also.


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## keithkarl200 (6 Oct 2009)

Don't get me started. I have been put on a course of medication until december and if its still the same he's referring me to a specialist


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## Brendan Burgess (6 Oct 2009)

Folks

Please remember the Posting Guideline. We don't discuss medical issues. 



> We do not discuss medical issues other than to provide links to support groups and medical forums. We do not allow recommendations for doctors, dentists or medical practitioners generally. We do not allow discussion of weight loss issues either as they always develop into either advertising or medical topics such as anorexia.
> 
> 
> You may discuss tax relief on medical expenses and pricing of medical services or health insurance. It is ok to provide information on the availability of emergency doctors or 24 hour pharmacies. But you should not discuss effectiveness of treatment or quality of care.


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## keithkarl200 (6 Oct 2009)

sorry, still kinda new on the forum, just venting a little anger


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## truthseeker (7 Oct 2009)

I dont feel that GPs are good value for money in a lot of cases.

OK if Im sick with something and I go and get medicine and it makes me better (or even if I go and its explained that I dont need medicine and it gets better).

But where I have an issue is if I have something that obviously needs me to see a consultant. I go to the GP and say 'Ive got this problem, I think I need to see a specialist' and the GP says 'yes, you do, here is a referral letter, 60 quid please'. The GP has done nothing here - just sent me elsewhere. I dont think referrals should cost the full price if nothing else is done in the visit.

Also on recurring prescriptions, I dont want to stray into discussing medical issues here but there are a number of types of prescription that really dont require a 60 quid visit - things like anti inflammatories/painkillers for long term (or recurring) orthopediac issues for example. The only way to get this medicine is to spend the 60 quid.

My GP also charges for repeat visits for the same problem - so if the 'cure' doesnt work the first time you could spend a number of 60 quid visits trying to find something that does work.


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## cocotv (7 Oct 2009)

*Hi everyone we're really interested in all of your comments could you please email me a contact number and I'll get back to you:

martin@cocotelevision.ie 

Or alternatively call me on 01) 4970817 *

Thanks


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## demoivre (7 Oct 2009)

truthseeker said:


> Also on recurring prescriptions, I dont want to stray into discussing medical issues here but there are a number of types of prescription that really dont require a 60 quid visit - things like anti inflammatories/painkillers for long term (or recurring) orthopediac issues for example. The only way to get this medicine is to spend the 60 quid.
> 
> My GP also charges for repeat visits for the same problem - so if the 'cure' doesnt work the first time you could spend a number of 60 quid visits trying to find something that does work.



€50 for a visit where I am, not sure about repeat visits with the same / related condition. Repeat prescriptions are €20.


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## bacchus (8 Oct 2009)

During a summer holidays in France, i had to go to the local GP. Paid €20. She was mortified to charge me that "much" considering she knew i'll get nothing back. She was even willing to reduce that rate shall i have not been able to afford it. She was relieved and shocked when i explained that in Ireland, i would have had to pay €55 and get almost nothing back from private insurance/med1.

GPs are the one profession which rewards mistakes: why should i pay for second visit, though at reduced rate, if i have been misdiagnosed the first time?


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## bb12 (8 Oct 2009)

€60 for my GP visits...the nurses used to always take your blood pressure and heart rate before you saw the doc, but you don't even get that now...i avoid the docs as much as I can these days and will offer suffer things out more than i used to.


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## Patrick2008 (8 Oct 2009)

Correct me if I am wrong but doesnt a GP have a duty of care to all patients? e.g if you go to your GP for a check up and he charges you say €60. Can you just say to him that you cannot afford it and agree to pay €40?


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## cocotv (8 Oct 2009)

*Hi guys, if you're leaving a comment and you dont want to contact us directly could you leave your first name and the county your from so we can read it out. Thanks*


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## Samantha (8 Oct 2009)

bacchus said:


> During a summer holidays in France, i had to go to the local GP. Paid €20. She was mortified to charge me that "much" considering she knew i'll get nothing back. She was even willing to reduce that rate shall i have not been able to afford it. She was relieved and shocked when i explained that in Ireland, i would have had to pay €55 and get almost nothing back from private insurance/med1.
> 
> GPs are the one profession which rewards mistakes: why should i pay for second visit, though at reduced rate, if i have been misdiagnosed the first time?


 

Bacchus, you should have use your European health card, you still have to pay the EUR 20.00 to the doctor in France but you get a partial refund via the CPAM in France for your doctor fees and medicine. I goes often in France with my kids to visit my family and sometimes if the kids are sick during our stay, it  will usually cost me around EUR 10 - EUR 15 in total for the doctor fees and medicine compared to the EUR 55 - EUR 65 in Ireland.


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## Patrick2008 (8 Oct 2009)

On numerous occasions I have questioned my GP in Knocklyon about their charges. As I have 2 young kids there are times when we have to visit the GP. We get charged €60 per visit. On each occasion we see a different GP as there seems to be a few GPs & Locums working from the practice. I am originally from Tipprary and when I was living there I used always see the one doctor so he knew me personally and he knew my medical history etc. He still charges €45. I questioned the receptionist at my GP in Knocklyon about their prices and she said they have not increased them in 3 years. I argued that my salary has dropped over 20% in 3 years not to mention the current state of the economy, deflation etc. There is no competition amongst GP's in Dublin and across Ireland for that matter. If more people questioned GP's on their fees then their fees might drop. And don't even get me started on GP's prescribing antibiotics for toddlers and babies. We met with one doctor who was from India and he was disgusted by how Irish doctors presrciber anti biotics for kids. My wife works for a large Pharma company and she has her own theories on this. 

Patrick. Living in Knocklyon, Dublin 16 but orig. from Tipperary.


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## square1 (8 Oct 2009)

My doctor really irks me. She charges €50 for the consultation, and €20 for a repeat prescription. However this is not a separate charge. For example - I get a prescription for every six months. Even if this is the only thing I visit her for I am charged €70. Thats €70 for her to take my blood pressure and write a prescription. Also if I go to her with a separate problem (I went to her with one recently which was not solved but which I am now unable to afford to go back to her on), and ask for this prescription she will add on the €20 charge. I think this is excessive. If I go to see her for just this prescription I expect the €50 to cover this and not to face an extra charge as the visit is of a nature she deems to cost more. 
I have decided not to go back to this doctor but at the moment have not found a recommended doctor still taking patients.


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## Towger (8 Oct 2009)

From : 				*Doctors (GP) Fees - No recession in my surgery*

http://www.askaboutmoney.com/showpost.php?p=892097&postcount=4

Towger, Dublin


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## mathepac (8 Oct 2009)

My guy never charges me - his receptionist does, €50 for a visit, €10 for repeat prescriptions and "whatever you have handy" for a repeat visit with an unresolved problem.


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## Sue Ellen (9 Oct 2009)

cocotv said:


> Hi guys, if you're leaving a comment and you dont want to contact us directly could you leave your first name and the county your from so we can read it out. Thanks



Most people prefer to remain anonymouse on AAM so might have a problem with this.  If you like you can use Brendan (as in Howlin) but definitely not John and from Dublin.

Leading on from GP charges are the consultant's fees which seem to differ greatly.   A relative had to visit 3 separate consultants recently and their fees ranged from €140 to €220 for similar consultations.  They found it hard to understand why there was such a difference.


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## roker (11 Oct 2009)

Consultants definitely should be brought in to this, they are worse than GPs with bigger charges.
I visited a consultant who sent me for a scan, I paid his fee and for the scan. He then made another appointment to visit him when he told me there was no problem. I was no more than 2 minutes with him, I did not even have time to sit down, he could have done this on the phone instead of me having to take time off work with loss of pay. I was then sent another bill for a consultation which I refused to pay.
People are afraid to challenge them because there is the underlying fear that there is something wrong with their health.


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## mct1 (12 Oct 2009)

I don't see any point in criticizing the doctors. The nature of the Irish health system has long been that two thirds of the population pay for GP care and then pay an extra whack for any medicines they need; whilst the other third pay nothing. That's the way it works. If I call out a plumber, visit a solicitor or phone my accountant, whether or not the problem is resolved to my satisfaction, I receive a large bill. It's often more than I was hoping it will be, but tough - I still have to pay. Personally, I prefer the NHS system, where - unlike the French system - the doctors have no incentive to over-treat, over-investigate or to give one patient more time or attention than another simply because they're paying. The NHS is far from perfect, but general practice over there is at least equitable.

In summary, I repeat that in my view, it's the healthcare system that is at fault - not the doctors who are obliged to implement it whether they like it or not.

Clare, Wexford


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## colin79ie (13 Oct 2009)

Unfortunately GPs are answerable only to their peers. This is where the problem arises from.

I had a child to the Doc recently with a chest infection. I have a bit of medical knowledge and could clearly see that the child needed an antibiotic. (Basic diagnosis is not rocket science)

Anyway he told me the child didn't need one and sent me off. €40. The next morning I deliberately brought the child back to him and whaddyaknow, immediately gave me an antibiotic. No apology or anything. Wanted to charge me another €40. I laughed and headed home.

Another thing which really bothers me is this; How many readers of this forum know of someone (mostly elderly people unfortunately) who were treated for months or even years with different antibiotics by GPs for various ailments, and then to discover they actually had cancer all along. I have never heard of  GP been held accountable for misdiagnosis in a case like this.
I personally know of 2 who have since died. If their cancer had been diagnosed early, I'm quite sure they would be here today.

C. Donegal.


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## liaconn (13 Oct 2009)

My doctor charges €60 for an initial visit, which is a bit much if you've just popped in with a  throat infection or a bug that's going around and all you need is a prescription and a cert for work (5 minutes max). To be fair to him he is very good about not charging for a follow up visit or only charging half price. I do think, though, that €60 is far too much for a routine diagnosis and a bit of discretion should be used here.

I think it's going to get to the stage where people will just put off going to the doctor until they absolutely have to in order to save money, resulting in further health problems down the line.


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## truthseeker (13 Oct 2009)

liaconn said:


> I think it's going to get to the stage where people will just put off going to the doctor until they absolutely have to in order to save money, resulting in further health problems down the line.


 
My GP told me that visits are way down since the recession started - its not like people suddenly became healthier, its for exactly the reason you state Liaconn.

In saying that, I believe many GP visits are not necessary, but one must go in order to get a cert for work. Last time I needed a cert I did not need a medical diagnosis, I knew I had a bug that was going around, i knew I did not need an antibiotic, I knew it was just a case of sweat it out for a few days - but I needed the cert for work so 60 quid was spent.


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## liaconn (13 Oct 2009)

I think the cert business is a big part of the problem. If you're dying with a cold, you know its just a matter of staying indoors and letting it take it's course. No need for a doctor's diagnosis there. But you need the cert, he can't give it to you without making sure you really are sick (if he's an honest doctor!) and therefore you have to pay €60 just to be told 'yes, its a bad cold alright, I'll give you a cert until Thursday'. Maybe  there should be some kind of a sliding scale of charges for an initial visit, although I suppose that could be open to arguments from patients. What do other people think?


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## truthseeker (13 Oct 2009)

liaconn said:


> I think the cert business is a big part of the problem. If you're dying with a cold, you know its just a matter of staying indoors and letting it take it's course. No need for a doctor's diagnosis there. But you need the cert, he can't give it to you without making sure you really are sick (if he's an honest doctor!) and therefore you have to pay €60 just to be told 'yes, its a bad cold alright, I'll give you a cert until Thursday'. Maybe there should be some kind of a sliding scale of charges for an initial visit, although I suppose that could be open to arguments from patients. What do other people think?


 
You see youre paying for a professional opinion, so if the opinion is just 'its a bad cold' thats just as valuable an opinion as 'this is a complicated problem that we need to treat by doing the following....'. But it feels very unfair that a 5 minute visit for a cert for work is charged full price.

I dont think you should have to pay if you are just being referred on. 
I also think that people should be allowed to self refer to consultants (I know some orthopediac surgeons are allowing this now). This business of needing a referral letter for a consultant is just a money spin in a lot of cases.

I dont think you should be charged full whack for repeat prescriptions or certs for work.

I also dont think you should have to pay to get x ray or test results that have been sent back to your GP - surely they could just phone you with the results and not make you pay for the pleasure (especially when youve already paid the GP to be referred for tests or x-rays!!).


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## Complainer (13 Oct 2009)

colin79ie said:


> Another thing which really bothers me is this; How many readers of this forum know of someone (mostly elderly people unfortunately) who were treated for months or even years with different antibiotics by GPs for various ailments, and then to discover they actually had cancer all along. I have never heard of GP been held accountable for misdiagnosis in a case like this.
> I personally know of 2 who have since died. If their cancer had been diagnosed early, I'm quite sure they would be here today.


If this kind of stuff is happening, then it should be reported to the Medical Council straight away.

My GP charged me €40 for a recheck on my blood pressure involving a change of medication, and advise on a simple head cold yesterday. He has explained to me right from the start that finding the right BP medication involves quite a bit of trial and error, and repeat visits and variations will be necessary.


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## bravo (13 Oct 2009)

A little off topic but probably relevant:
Did I read very recently that some nurses will shortly be able to prescribe medication? Maybe this is just in hospitals. But does this move not clear the way for simple perscription drugs to be issued without doctors fees?


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## Guest122 (13 Oct 2009)

I mentioned some of the topics of this thread to a doctor I know (not my GP) and she basically said, “If you don’t like it, go to another doctor”.

But I said, that my GP has closed their books to all new patients and she said, “Yes! So have I”

I think we need a lot more doctors here practicing to add a bit of competition, patient respect etc.

Am happy enough with my GP apart from the fact that an appointment can happen anytime up to 3 hours after scheduled time.

How hard is it to keep a diary of appointments and keep to it.
If emergencies arise (seemingly every day) allow some time in the day for emergencies.


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## Towger (13 Oct 2009)

Breffni Boy2 said:


> I think we need a lot more doctors here practicing to add a bit of competition, patient respect etc.



The number of Irish Doctors allowed to train each year is fixed by the (I believe) the Medical Council.


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## z107 (13 Oct 2009)

> The number of Irish Doctors allowed to train each year is fixed by the (I believe) the Medical Council.


Well there we have the root of our problems.
As long as this is the case, we will have a cartel.


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## liaconn (13 Oct 2009)

I used to go to a GP who was constantly thinking up reasons not to charge people, 'no, you were kept waiting for ages', 'that's alright, sure it was a simple matter' etc.  His wife owned a Chemist shop beside the surgery so people used to make sure to get their prescriptions made up there in order that he got some financial recompense.

Unfortunately, he left the practice to return to college .


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## z107 (13 Oct 2009)

> Unfortunately, he left the practice to return to college


Business college?


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## Eithneangela (13 Oct 2009)

In the last six months, my husband has visited both his GP and 2 consultants, all of whom have increased their prices by at least 10%.  Outrageous.  He has to visit the consultants on a twice annual basis, and pays at least €140 on each visit for approx 15 mins.   The GP basically organises blood test documentation and writes out the same prescription for the ongoing ailments.  A trained monkey could do the same.  I've given up on GP's - got my initial prescription for ongoing ailment and now buy over the counter on the Continent, for a quarter of the price.  My last GP spent the appointment updating his laptop computer - never once looked at my or asked general questions about health and well-being.  Cartel it is - and the sooner we can break it up, the better!


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## annet (13 Oct 2009)

In my local GP practice – the fees for private patients is €55 per consultation, €10 for repeat scripts, and irrespective of whether one is a private or GMS/GP visit cardholder €25 for practice nurse consultation and to have bloods taken, and a charge schedule for male and female health and travel vaccination charges.  The annual flu vaccination programme is also being currently being rolled out within the practice for vulnerable groups at a charge of €35 per private patient – although it is free to GMS or GP visit cardholders.  

If you need a sick note for work that will cost a private patient €10 and if you require a DSFA cert the GP will receive a fee of €8.25 from the DSFA for each cert they complete and €44.44 per DSFA medical report.  

We have all heard of the payments GP’s received for so called “ghost patients” under the GMS – but GP’s also receive HSE grants as far as I know to employ practice nurses and secretaries when they are participating in the GMS – so why does GP’s levy a charge on cardholders to receive services from a practice nurse when they are receiving grants to employ them under the GMS system maybe something that warrants further investigation. 

We also hear that the H1N1 vaccination is also going to be provided by GP’s and that the HSE is going to pay a GP €10 for each vaccination – but my question is whether these GP’s are going to levy an administration charge on private patients so that in addition to receiving the fee from the HSE they will receive a fee from the patient for receiving and administering this vaccination.

We have heard within the health strategy 2001 government vision to strengthen primary healthcare in Ireland so as to ensure that healthcare is delivered in the most appropriate setting ie. primary care environments as opposed to acute hospital care.  This strategy was suppose to promote an integrated approach to delivering primary healthcare services by 2011 with the Strategy also identifying that services that were and still are currently provided in hospital services could be provided within a primary healthcare setting.  We are now coming to the end of 2009 and my question is how many GP cooperatives has there been delivered under the Primary Health Care Strategy?  What is the broad range of services currently provided in GP practice?  We obviously have GP’s and practice nurses who provide a minimal range of services and who continue to act as gatekeepers for access to secondary health care – but apart from those provided by private healthcare providers we don’t have public funded minor injury units in primary care, and are far from achieving a model of all services under one roof from community mental health services, social workers, dieticians, speech and language services, home helps, health care assistants, chiropodists, physio, OT’s, psychologists or minor investigations.  While government and Mary Harney may profess this to be their vision – we all know that our health infrastructure, nature of GP and primary care system or even our direction in health policy does not support such a model of delivery.

Another poster raised the issue of the medical council – there was an old saying – “there is no accountability in self-regulation”…. whether that person is a doctor, solicitor or accountant.  The board of enquiry in the medical council is now composed of both professional and lay members of the public and how effective this new composite will be in terms of delivering greater accountability in this profession is something that maybe will warrant future investigation.


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## liaconn (14 Oct 2009)

I actually suspect that when the income levy was introduced a lot of GPs and Consultants just upped their fees, passing it on to their patients who are already paying the levy on their own salary.


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## sandrat (16 Oct 2009)

When I was pregnant I did combined care which means you get free GP visits. my GP told me I got a maximum of 6 visits for free and that this included one post natal visit. 

I visited him once for a social welfare cert when I was unable to attend work and he counted this as one of the visits. Also attended for a problem which was pregnancy related in a way but not a normal ante natal visit and he charged me 50 euro. He told me I had run out of visits 4 weeks before due dates and advised that I should ask to be induced early because if I had to see him again before baby was born he would have to charge 50 euro per visit.

Needless to say this person is no longer my GP


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