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Lazy golf-playing, arse scratching Irish docs costing the elderly their health.

Posted Oct 18 2008 4:57am
Posted by: Dr. Thunder

I read this yesterday. It's a short article in the Irish independent:


The Tanaiste is putting pressure on doctors to reduce the amount of money they receive to provide healthcare for elderly medical card holders. Mary Coughlan has indicated that if GPs were prepared to take less money, the Government could readdress the abolition of universal medical cards for the over 70s. There has been uproar since the Government announced in the Budget on Tuesday that they would be scrapping the scheme, which automatically entitles every person over 70 to a medical card.The Minister for Health issued modifications to scheme last night.People on the State contributory pension will still qualify, and those over the threshold will receive either a GP-only card or a €400 annual payment, depending on their financial situation.

I think the Irish government are taking lessons in spin from the British government. When I was a paediatric SHO in the UK, all ills were blamed by the government on doctors. We were told we didn't work hard enough. We were told we weren't efficient enough. Patients were told not to let us hold them to ransom.
Then they went to town on the GPs. The Labour government said they were going to sort out those lazy bastards. They told GPs that they'd be paid ONLY for the work they were doing. They had made the assumption that GPs didn't work hard. Everyone working in the NHS knew that was a crock of balls. But I guess people in ivory towers in london don't really get the coal-face view.
Anyway, they paid the GPs for EXACTLY what they did. And it almost bakrupted them. The government soon found out just how productive British GPs are. So, they got paid a lot of money. Not the 250,000 pound salaries that the media talked about. But nonethless the GPs mostly got a payrise, as they were now being paid for work they previously did for free.

So, now the irish government are following suit. Our deputy prime minister (known as the Tanaiste in Ireland) is engaging in a bit of damage limitation. She has had to tell pensioners in Ireland that there's not enough money to provide primary healthcare for them.
But that's bad news. It doesn't look good for the health service when politicians have to make tough decisions that involve curtainling healthcare. That doesn't bode well for the next election.

So, they tell the public that the reason for their piss-poor healthcare provision is that GPs are over paid. They want them to take less money, to help the government out.
Now, I'm not a GP. But if I was, I'd be telling Mary Coughlan to take a jump.
The governement negotiated a contract with GPs, and now suddenly they want to change the terms of that agreement. They know no lawyer is going to be able to pull that off by force, through legitimate channels, so they use this disgusting spin.

"Old people can't get free healthcare because doctors are too greedy". Why are doctors the only group within the health service being asked to take a pay cut? Sure, they have to be paid, but so do lots of other people who are involved in the running of the medical card system. Admin staff, accounts staff, politicians and advisors are all taking a cut.

I would argue they're all less efficient parts of the equation than the GPs.

The Irish government tried this recently with the pharmacists. They decided they didn't like how much they were paying them, so they tried to bully the chemists into taking a big cut in their remuneration. That was equally as cynical, and it didn't work.

My advice to the health service executive is the look at the big picture. If you want doctors to work with you, and cut you some slack when they're senior enough to GPs....then stop treating them like crap when they're juniors.

Who is ever going to feel any loyalty to a health service that breaks them down to the point of emigration??

So, should GPs take a pay cut? Or are there other ways of making the health care system efficient enough to, well, provide healthcare?
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