Sir, – Dr Eluned Lawlor (February 3rd) reported that our Minister for Health does not believe that granting under-sixes medical cards will cause a significant increase in workload.
Obviously he is not aware of two of the most recent studies on the subject. One, published by the ESRI, looks at the increase in private patients' attendance rates when they are granted a medical card. The other was a cross-sectional audit of general practice records nationwide, published by the Irish Medical Journal . It highlights the higher adult visiting rates of those with GP visit card, full medical card and discretionary medical card when compared with private patients. Both predict a change in GP attendance rate associated with acquiring a GP Visit Card of 1.5 to two extra visits per year in the adult population.
A more recent audit of the same practices involved in the IMJ paper show an extra attendance in under-sixes GP Visit Card patients compared to private patients of 2.5 visits per annum. Full medical card patients in that age category attend four times more per annum. Those figures do not include the increased workload associated with the proposed mandatory adoption of the internationally discredited policy of offering annual health checks to all children. It should be noted that such a policy is proven to contribute to health inequalities via the inverse care law. Those who have the highest healthcare needs benefit least from universal programmes as their health requirements need to be specifically targeted.
Should Irish healthcare policy be based on reliable data or should it be purely politics driven? – Yours, etc,
Dr WILLIAM BEHAN,
General Practitioner,
Cromwellsfort Road,
Walkinstown,
Dublin 12.