Health insurance and GPs’ earnings

Sir, – GPs nationally welcome Leo Varadkar’s plans to defer universal health insurance. As talks about it progress, it is looking more and more like the US healthcare system, where up to 30 per cent of all healthcare costs are swallowed up by insurance companies in administration costs, legal fees and profit-taking, with no regard to the cost-effectiveness of the service.

However I am surprised that the new Minister considers free GP care an option in the near future. He is obviously not aware of the current problems caused by the advantage taken of the Financial Emergency Measures in the Public Interest (FEMPI) by his two predecessors.

Between 2002 and the 2013 FEMPI/Haddington Road reduction the average State funding per HSE employee had risen by 50 per cent, due to increments for time in service, grade inflation and extraordinarily generous pensions; the consumer price index had increased by 24 per cent but the payments to general practice per GMS patient were lower in 2013 than they were in 2002.

The 2013 FEMPI resulted in a further €34 million being taken out of general practice. The recently published OECD earnings data for Irish GPs indicate that had the Haddington Road cuts been applied fairly to general practice, less than €5 million would have taken.

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Massive underfunding of the most cost-effective element of the health service, in association with the culture of prioritising political and bureaucratic gains over patient-centred outcomes, are guaranteed to stall any further progress in this area of healthcare. Yours, etc,

DR WILLIAM BEHAN,

Cromwellsfort Road,

Dublin 12