Sir, – Your article on general practice fees (Pricewatch, Business supplement) refers to transactions that would not reflect reality for most patients.
Being charged a full consultation fee for a sick note in the stated circumstances is at odds with nationwide practices where the bill for the same service would commonly range from no fee up to €20. Paying the full cost for two adults, never mind two children attending at the same time is also very uncommon; very often there is no extra fee for the second child.
I agree that charging €60 for a repeat prescription is outrageous, unless there has been an extensive (and possibly forgotten) consultation associated with the service.
The average GP fee is generally reported in the national media as being either €55 or €60. The National Consumer Agency March 2010 survey that is referred to in the article was an audit of 123 practices nationwide. That number of practices would represent about 280 doctors and patient population of well over 400,000. It assessed the national average maximum GP fee to be €51. Practice nurse consultation charges would generally be half the GP rate. Not many GPs have reduced their headline fee since then, but most of us have reduced our rates for private patients who are in financial difficulty and we are not charging more frequently for full consultations, reviews or multiple consultations.
Considering those reductions, along with the proportion of complex consultations that occur over the telephone, the true average fee per consultation is probably €35-€40 nationally and research shows that the average GP deals with two to three problems per consultation.
Exceptional cases do not fairly represent usual general practice fees. Therefore it cannot productively serve informed discussion but only serves to polarise opinions.
Patients should choose their doctor based on criteria such as their (admittedly perceived) overall competency and accessibility as well as cost. As Stephen McMahon of the Irish Patients Association says: patients can shop around. They can also tell their GP what their financial situation is; because no matter how brilliant some of my peers appear to be, they don’t always get their mind-reading spot on! – Yours, etc,