IRISH MEDICAL ORGANISATION CONFERENCE:THE RECESSION has led to increasing numbers of patients turning up at GP surgeries seeking to be certified as unfit for work so their social welfare entitlements can be continued or increased, the annual conference of the Irish Medical Organisation (IMO) was told yesterday.
Dr Ronan Boland, chairman of the IMO’s GP committee and a GP in Cork city, said he had seen more people who were referred by social welfare officers who suggested to them they should see if they could be certified for long-term disability payments “sometimes on dubious grounds”.
Some cases were straight forward but some were “greyer”, such as when a person had asthma. Doctors could be left in an invidious position choosing whether to “stretch the balance” and certify the patient or leave the patient without the resource to pay their bills. “It’s something I’ve noticed a lot more of in the last three to six months,” he said.
During a session which considered the impact of the recession on health and medicine, Dr Boland also said GPs were seeing more people presenting with stress related to financial difficulties and occupational uncertainty, as well as more people presenting with drink and drug problems.
There was also evidence parents were putting off going to their doctor for as long as possible when they were ill.
With more than 430,000 people now signing on the Live Register, more people were seeking and qualifying for medical cards, he added. But there were sometimes real difficulties in people getting the benefits to which they were entitled, such as long delays in the process of medical card applications.
Meanwhile, he said GPs had seen their incomes go down as a result of a cut in their fees for treating medical card holders last year, and another fee-cut has been signalled. He said a survey of hundreds of GPs by the IMO in January found 21 per cent of practices had let staff go as a result and 67 per cent indicated they would have to reduce staffing levels if their fees were cut further. This could result in surgery hours being cut and more patients having to go to hospital instead.
Prof Charles Normand, a professor of health policy and management at Trinity College, said the risk of dying, while low, doubles for people who are made redundant, regardless of their age. At the same time, he said, people who are in employment recover faster from illness.
He also predicted the numbers who will cancel their private health insurance policies will increase significantly as the recession continues. But he said with some private hospitals only half full, it is possible that this will lead to lower prices and better value insurance.
He stressed that while there has been much debate about the future of Quinn Insurance, it contributed just 2 per cent overall to health spending each year. The reduction in funding to the HSE this year as a result of the recession was four times that, he said.
He also said the recession provided an opportunity to improve hospital efficiencies and there were ways to do things better for less.
For example, he said the evidence was now clear that we should only be recalling women for smear tests every five years, rather than every three years. “We are just in the process of setting up the wrong system,” he said, pointing out that more harm than good could be done by screening women too often. This was because women with suspect smears, that would never turn out to be cancer, were being treated and treatment could lead to infertility or other problems.