Madam, - The current media obsession with alleged overpayment to doctors for the treatment of ghost patients is predictable and regrettable. Predictable because doctors have traditionally been a soft target for criticism in the area of income and lifestyle. Regrettable because the entire debate moves the focus away from the substantive issue involved.
The figure of €6 million is probably accurate but entirely misleading. As is stated in one of your articles general practitioners received an average excess payment of €2,296 spread over 14 years. Even allowing for the bulk of payments occurring within a five-year period, the average overpayment would equate to less than €500 a year. Given that the GMS income of my practice would be about €120,000 a year, we are talking of an error in payment well below 1 per cent.
Before people focus on the income level of €120,000, let me point out that my practice employs a receptionist, a practice manager, a part-time nurse and a sessional psychologist. I am then left to pay rent and all administrative costs of a busy urban practice.
At the a.g.m. of the Irish College of General Practitioners last May in Galway a motion was passed expressing concern that medical cards were given to patients for reasons other than medical or socio-economical grounds. There was a debate as to whether the word "concern" in the motion be changed to "outrage", such was the level of feeling from the members. The motion was passed unanimously.
The decision to grant medical cards to people over 70, irrespective of their income, was a decision taken by Government shortly before Budget day in 2001. It was taken without any background research and without any consultation with the doctors who were expected to deliver the care. This decision ranks as one of the greatest social injustices perpetrated on the people of Ireland.
To move the focus away from this injustice we now see regular attacks on the soft target of doctors' income. This also hides the reality of the situation which is that doctors are frequently not paid for work performed. For example, when an infant is born to a medical card mother, care is provided free of charge from the moment of birth. The mother must register that child in order for the doctor to be paid. This registration may not occur for months and in some cases for years.
A medical card is issued for a set period of time. Thus, it has an expiry date after which the person is not covered and the doctor is not paid. A case in my own practice involves an adult with a severe learning disability who also has epilepsy. He depends on his mother to conduct all his business, but she is a single parent trying to manage her five other children. When his card lapses, as it frequently does, we provide care free of charge and prescribe medication, as it would be totally unethical not to do so. For those who think this is an isolated incident, I can assure you that the GPs of Ireland have many such cases. - Yours, etc.,
Dr NIALL Ó CLÉIRIGH,
Sráid an Phiarsaigh,
Baile Átha Cliath 2.