Madam, - We wish to comment on an article on doctors' fees in your edition of February 10th. We were quoted as having the lowest fees in the Dublin area, which is probably true. However there are certain issues which need to be clarified.
This practice has the advantage of working from health board-owned premises and so not paying heating or electrical costs. The practice serves a large population of medical-card patients and under the Drug Budgeting Scheme we have made savings which we use to invest in infrastructure.
This is not available to doctors with small numbers of medical card patients.
We employ three receptionists, a practice manager and two practice nurses. We are also fully computerised. This would not have been possible if we did not have the advantages mentioned above.
In effect our GMS patients subsidise the €30 charge, which is completely uneconomic. It is still often more than our patients can afford. However, we are able to subsidise our fee because of the above. Most of our colleagues do not have this luxury.
Once again, the issue is not about the uneconomic low fee charged by some doctors; it is about the continuing increase in the number of people who are losing medical cards on an excessively low means-tested basis. This cohort of patients just above the medical card threshold is being consistently denied access to primary care.
The Government must honour its pre-election promise of increasing the medical card numbers. - Yours, etc.,
Dr DAVID GIBNEY, Dr BRID HOLLYWOOD, Dr ANNE LYNOTT, Dr MARY JENNINGS, Dr TARA CONLON, Ballymun Health Centre, Ballymun, Dublin 11.