Madam, - I am curious to know if Seán Byrne is writing as an interested observer or in his capacity of lecturer in economics at the Dublin Institute of Technology ("Doctoring the pay system", HEALTHplus, November 18th) . If it is the latter, I can only describe the article as disingenuous as in my view he blurs the boundary between fact and anecdote to suit his thesis.
He uses 2006 income figures for 18 doctors to further his argument. These figures are patently not representative and he conveniently omits to mention that the infrastructure required to provide services is funded by the individual GP out of this income. This infrastructure involves premises including all the usual costs associated (maintenance, insurance, rates) utilities, furniture, equipment, computers, etc, as well as staff salaries. Those on the higher incomes cited, apart from paying secretaries and nurses (larger practices would have at least two of each), are probably employing at least one other GP.
His statements that "capitation systems. . . lead to shorter (and sometimes careless) consultation" and that "treatments Irish GPs now provide are very limited. . . partly due to fear of litigation" are unsupported and vacuous.
His assertion that he "is always amused to see GPs' plates that describe them as physician and surgeon" suggests that he needs to get out more and, while at home, write something more erudite befitting his position. - Yours, etc,