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Tuesday 6 December 2016

Free GP care for under-sixes puts everyone's health at risk

Lorraine Courtney

Published 10/04/2015 | 02:30

Health Minister Leo Varadkar, pictured, as a new poll carried out by Amarach Research revealed 'Only one in five people support free GP care for the under-sixes'
Health Minister Leo Varadkar, pictured, as a new poll carried out by Amarach Research revealed 'Only one in five people support free GP care for the under-sixes'
"The Minister for Health Leo Varadkar is resorting to a populist policy that is both daft and dangerous, when what we really need to do is charge people based on their medical needs coupled with their financial need"

Free GP care for under sixes - who could argue with that? But between paper and practice there's often a big reality check. We know full well that such universal measures, without recourse to means testing, are like writing a blank cheque.

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The crazy thing, from the Government's point of view, is that it simply doesn't need to engage in this oversell. Only one in five people support free GP care for the under-sixes, according to a poll carried out by Amarach Research.

Chris Goodey of the National Association of General Practitioners says: "GPs are not in favour of this. The public is not in support of the scheme. So why the Government is insistent on railroading it through is beyond me."

The notion of free GP care regardless of a person's wealth is a bad use of resources and a very impractical one. We will soon have the unedifying sight of mothers drawing up in 4x4s demanding free Calpol for their child. If the Government really wants a system based on need, should someone earning €100,000 a year receive the same free GP care as their neighbour who is on social welfare?

But the real problem with the proposal is that free GP visits are a hypochondriacs' charter. If it's free, you go time and time again, with a headache, a single sniffle for the antibiotic you don't actually need but will be handed out anyway.

The shock of having to pay to see a doctor is palpable and the only sensible impediment to the casual GP visit. And with GP fees of €50 and upward for a single visit, it's a lot to part with for a sniffle, no matter how annoying it is.

All the statistics show a clear link between the cost of a GP visit and the propensity to visit a GP. Medical card patients attend their GP twice as much as private patients, according to a 2013 study. The researchers analysed the GP consultations that took place with more than 20,000 patients, aged 18 and older, in six general practices over the 12-month period from October 2012 to October 2013.

The figures showed that around 24 million GP consultations take place every year in Ireland - 15 million of which are with medical card patients. Researchers also pointed out that if private patients were to attend GPs at the same rate as medical card patients, this would lead to a whopping 4.4 million extra consultations per year.

The payment to GPs is expected to be set at around €75 a year for each child for the proposed scheme. If the child does attend the average seven times, that works out at just over €10 per consultation, regardless if that is a house call to an out-of-the way rural location.

This is extremely worrying, since there is so much dissatisfaction already within the GP profession. Just one in four recently qualified GPs or trainees surveyed by the Irish College of General Practitioners plans to stay in Ireland for definite.

There's a very real danger to health too.

Roll out free GP care for all the under-sixes and soon getting to see a GP will feel like an assault on Fort Knox. It can only end up lengthening waiting lists and draining resources - just like the two-week waiting lists on the UK's NHS. Average consultation times will shrivel back to a paltry few minutes.

And A&Es will be even more clogged with people who are not that sick but have given up on their GP.

Patients who attend too often might not always have their symptoms taken seriously by a GP with an overflowing waiting room, and in cases like meningitis, over-concerned parents could bring their child to the family doctor before symptoms have fully developed, leading to misdiagnoses.

The Minister for Health Leo Varadkar is resorting to a populist policy that is both daft and dangerous, when what we really need to do is charge people based on their medical needs coupled with their financial need.

A nominal fee could be imposed on everyone. Those on higher incomes could pay more and people who waste the system's time would be penalised.

But sense doesn't have a place in pre-election times.

Irish Independent

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