Sir, – I refer to the letter from Breda Sweeney (March 30th) wherein she refers to paying €400 for a first-time medical consultation, a charge she finds hard to justify. She also comments that patients do not have the option to shop around.
The referral decision to a consultant is primarily made by the person’s general practitioner based on their knowledge as to who is best qualified to treat that patient’s medical condition. In the private healthcare system, unlike the public system, the patient may decide to check with family or friends, or their health insurer and, having done their own research, they select the consultant to which they prefer to be referred.
As regards the fee charged, in a free market, a consultant is entitled to determine their own fees for out-patient consultations. The charges made will be determined by the practice’s overheads. These will include, among other things, medical indemnity insurance, general insurance, IT and utility costs, rent of rooms, staffing costs, minor procedure or practice consumables and taxes and social insurance.
Consultants in full-time private practice, unlike those employed by the HSE, do not have their practice costs subsidised by the State.
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In a hospital setting the consultants’ fees are set by the health insurers and here again there are huge discrepancies between the benefits paid by the insurers – something that the Health Insurance Authority continues to fail to investigate and which is undoubtedly a factor in driving up the cost of health insurance premiums. – Yours, etc,
JAMES E NORTON
Castlecomer,
Co Kilkenny.
