Our nearest neighbours have had free GP care for 50 years. Yet here, we still have to pay a cruel price for being sick

By Roslyn Dee

MY parents live a threehour drive away from me. They are both in their 90s and, despite the fact that 30 years have passed since I first explained the situation to them, they still can’t get their heads around it – that when I need to see my local GP, I have to pay for the privilege.

It is a system, according to my mother, which is ‘ridiculous’ and ‘unfair.’ How on earth do people with lots of children, even if both parents are in gainful employment, cope with that, she wonders? Indeed.

My parents live in Co. Derry and enjoy all the benefits of the NHS. I live in Co. Wicklow and have to fork out €55 whenever I vist my GP.

Now, I have to state here, from the off, that I have a brilliant doctor. It’s a long- established practice with three GPs, my own preferred doctor having a particular commitment towards community medicine.

You’ll find lots of small children on the books, and elderly people, and a nurse in residence for whose services there is a considerably reduced fee. And they open at 8am every day and have three late-night surgeries a week.

It’s also a practice where they don’t charge for follow-up visits and, even for a related- condition, second appointment, at some time remove from the first, they still charge a reduced fee. Nor do they ask you to cough up anything at all for repeat prescriptions.

Commitment

So, in the greater scheme of how things are in this country, I am lucky enough. For this, in essence, is a practice that puts the patient first – in so far as they can. With the current health system set-up in this neck of the woods, they are running a business, after all.

The findings of the GP survey in this newspaper yesterday reveal some startling statistics, not the least of those being that GP charges vary from €30 to €65, depending on the location and the specifics of the practice.

There are, of course, a number of mitigating factors dictating this fee – property prices are affected by location, after all, and for some practices, what they have to pay out in rent or repayments has to be reflected in the charges they pass on to patients. But there is also, in some cases, another factor – greed. It shouldn’t be like this. This isn’t healthcare – not in the strict meaning of the term.

For where i s the ‘ care’ i f, effectively, paying a visit to the doctor when you are anxious about your health is actually something that you cannot afford to do? Pay for your child’s schoolbooks or get that cyst checked out? For many familes, that’s a no-contest question.

How long now have we heard James Reilly waffling on about ‘universal healthcare’? He was very hot on the subject when he was in Opposition.

Indeed, he pontificated about it so much back then that you’d have thought he had dreamed up the concept all by himself. Now, two and a half years after sitting around the Cabinet table as a Government minister, he is still waffling on – and still we have no concrete date f or change.

Back i n April 2012, j unior health minister Róisín Shortall announced t hat a phased introduction of GP care had been approved. She was determined to make this happen but she clashed with James Reilly, and we all know what happened to Ms Shortall. Earlier this summer, just a couple of months ago, in fact, and more than a year after that Róisín Shortall announcement, Enda Kenny reiterated that the Government still had plans in place to introduce free GP care for everybody within the next three years. That time parameter pushes things out until the summer of 2016. So why do the goal-posts keep moving?

Surely free GP care is fundamental to an equitable and efficient health service. Yes, I know that we have the medical card system (‘Doesn’t that make people feel like second- class citizens?’ asks my still sharp-as-a-knife father. Answer: Yes.), but what about people who fall in the middle?

That’s those with an average income, two or three children, and very little disposable money. In that situation a few GP visits a month with young children can simply smash the family budget to smithereens. There is, literally, nothing left.

The British NHS system is not perfect. In some places you might have to wait days for an appointment but, largely, if you have a genuine health concern, you will be ‘squeezed in’. Apart from my own experience of growing up in the North, I also lived in England for some years and that was certainly the way it operated there.

The NHS is abused, of course, by those who believe that if anything is ‘free’ then you should make the most of it.

Smithereens

Human nature i s human nature, and not all human nature is of the admirable variety. But for every chancer or hypochondriac or person who is just plain lonely found sitting in a GP’s waiting room in Britain or in the North, there is a myriad patients who are genuinely in need of medical attention. And for many of them, if denied the safety blanket of a free consultation, they just wouldn’t be there at all. They couldn’t afford it. What kind of a third-world way is that to operate any health service?

Yet we do i t here i n the Republic. It’s all very well to say that those who can afford it should pay for it, and those who can’t should be supported. (Back to that second-class-citizen medical card.)

But it’s not as black and white as that – these things never are. And even if you take basic dignity and respect out of the equation – as in medical card patients often being prescribed less -effective drugs than a more expensive equivalent as per an instruction to GPs from the good old HSE (anecdotal evidence, yes, but from a sound medical source) – it’s always those in the middle who suffer most.

And anyway, you should never be forced to take dignity out of any equation.

We need to sort this out. And sorry, Mr Kenny, but we can’t wait for another three years. Nothing is more important than the health of a nation’s citizens.

Our elderly are being looked after when it comes to GP care – at least under Bertie Ahern Fianna Fáil did one thing right, and all those over the age of 70 have been eligible, since 2001, for free GP care.

But that’s just one section of society and we ar e still struggling here under an inequitable, two-tier health system.

In the North, my parents have both been blessed to reach the tenth decade of their lives. They have enjoyed all the benefits throughout their long span that the NHS, since its inception, has bestowed upon them.

Here, we bountifully dole out free GP care to those who reach the age of 70 and think we have done our bit.

Well, we haven’t. And for many of our citizens, the struggle lies in actually reaching – without loss of health or dignity – that biblical milestone of three score years and ten. Surely we all deserve better than that.