Cabinteely Park - Under 6 GP plan

100gSoma

I should disclose I have 2 kids under 3.
My local clinic is a conglomerate of 6 GPs. They have collectively decided not to sign up to the HSE under 6 GP contract.
One of the GPs explained that they would 'lose out financially so have decided to opt out'. Currently a visit costs €65 for my child. (I have two under 3).
So obviously it makes sense to change to a new GP who is signed up. It's just a real shame to have to move from a GP who knows our children and our family medical history and background etc and start from scratch with someone new.
I don't understand how they lose financially by signing up, because if I have to take my children elsewhere I certainly won't be going back myself or any member of our family. Surely that is a bigger loss? After years of paying 65 a visit, this feels like a big two fingers to their loyal clients.
Am I missing something? Ar they really losing that much financially?
edit: There are some other options of GPs who have signe dup in nearby villages. Deansgrange, Foxrock, Stepaside etc. but a couple I have tried stated 'their book was full' and are primarily signing up children of their current clients. that makes sense I suppose. anyone else in a similar situation? Any suggestions?

Bayberry

100gSoma wrote: »

I should disclose I have 2 kids under 3.
My local clinic is a conglomerate of 6 GPs. They have collectively decided not to sign up to the HSE under 6 GP contract.
One of the GPs explained that they would 'lose out financially so have decided to opt out'. Currently a visit costs €65 for my child. (I have two under 3).
So obviously it makes sense to change to a new GP who is signed up. It's just a real shame to have to move from a GP who knows our children and our family medical history and background etc and start from scratch with someone new.
I don't understand how they lose financially by signing up, because if I have to take my children elsewhere I certainly won't be going back myself or any member of our family. Surely that is a bigger loss? After years of paying 65 a visit, this feels like a big two fingers to their loyal clients.
Am I missing something? Ar they really losing that much financially?
edit: There are some other options of GPs who have signe dup in nearby villages. Deansgrange, Foxrock, Stepaside etc. but a couple I have tried stated 'their book was full' and are primarily signing up children of their current clients. that makes sense I suppose. anyone else in a similar situation? Any suggestions?

health.gov.ie wrote:

Having considered the outcome of the discussions with the IMO, the Minister for Health has determined that an annual capitation rate of €125 per patient shall apply, with enhanced capitation payments in respect of children covered by the asthma cycle of care, at €50 for year of diagnosis and €45 for each subsequent annual check.

http://health.gov.ie/blog/press-release/ministers-welcome-agreement-with-imo-on-free-gp-care-for-under-6s/

Apparently that's what the economics of it are for doctors - if they expect to see children more than twice a year, then they'll be getting less money under the new scheme. If they're already too busy, they don't just lose the additional fee that yu would pay, they will also have less time to deal with other patients. And if they are that busy, and have enough people waiting to get on their books, then they can afford to lose your other business as well.

There's more to it than just the money though - my understanding is that many GPs are entirely unhappy about the scheme is being imposed on them. And I don't get the impression that, on these fees, GPs are exactly minting it (though I don't know any GPs on a personal basis, so I don't know).

coylemj

Dare we ask if the GP practice would lose money if they did sign up for the scheme and you continued to attend there with your two children? Put another way, how many times a year do you bring your children to visit the GP?

Once it becomes free to do so, there is going to be an increase in the incidence of mothers bringing their toddlers to the GP and this in turn will put pressure on the practice in terms of longer queues in the waiting room and longer working hours for the individual doctors. A place like Cabinteely would have a relatively low incidence of medical card holders so relative to other parts of the city, that GP practice would probably see a bigger increase in frequency of visits if they sign up to that scheme.

100gSoma

good points in both comments. I agree that €125 per year per child is undervalued. I'd say I took my child to the doctors maybe about 3-4 times per year. That was our first child. The second I would take less as you know a bit more and tend not to be overly concerned with minor ailments as much. Either way the €125 the government offered is probably slightly under valued. I don't think all GPs charge 65euro per visit either, so it obviously hits the expensive clinics more.

I absolutely agree that more children in the waiting room is less opporutnity to make 65euro per consultation from paying patients, especially in a low medical card area like cabinteely. I think any family who moves their young child to a new clinic will not go back themselves or with their older kids. why would they. Easier to keep everyone with the same clinic. so that's something that the GPs need to consider too. Obviously they have done all the math and decided it's not worth it for them. €200 a year HSE payment would have been more realistic for an area that charges 65euro per child visit.

ted1

Bayberry wrote: »

http://health.gov.ie/blog/press-release/ministers-welcome-agreement-with-imo-on-free-gp-care-for-under-6s/

Apparently that's what the economics of it are for doctors - if they expect to see children more than twice a year, then they'll be getting less money under the new scheme. If they're already too busy, they don't just lose the additional fee that yu would pay, they will also have less time to deal with other patients. And if they are that busy, and have enough people waiting to get on their books, then they can afford to lose your other business as well.

There's more to it than just the money though - my understanding is that many GPs are entirely unhappy about the scheme is being imposed on them. And I don't get the impression that, on these fees, GPs are exactly minting it (though I don't know any GPs on a personal basis, so I don't know).

its worth more to them than the 125, there are capitation grants etc to help cover the cost of the practice. Its closer to 240.

125 is plenty, Some kids don't go at all. Some kids go 4 times. It balances out well.

helimachoptor

because kids are free.. they will be brought more which means appointments for paying customers get booked up, which means they might go elsewhere.

fwiw, my wife is in the park (i'm not) but she has called them and they arent doing the scheme so she'll be moving GP.

My own clinic isnt on the scheme either.

coylemj

That practice in Cabinteely may also have made the decision not to participate in the under-6 scheme because it is their intention not to be sucked into the long-term plan for free GP care for all. If we end up in a situation where everyone can go to their GP for free, every doctor operating in a GP practice will effectively become an employee of the state and have the HSE dictate their earnings. Not every doctor wants to end up in that situation. You don't really have much choice if you're in an area with a high concentration of medical card holders but you certainly do in a place like Cabinteely.

In parts of the UK it takes three weeks to see a GP (which in turn puts enormous pressure on the local A&E) and the NHS has to effectively bribe newly qualified GPs with extra money to go to parts of the UK where there is a shortage of doctors.

Giving people free GP care sounds great but I used to work for a company where we had free access to a GP on two days a week. He operated from a room off the reception area so you could see the same people week in week out coming out with their prescription for an imaginary illness. As with a lot of other things in life, give people something for nothing and they will abuse it.

ted1

Free GP results in early diagnosis which frees up beds in hospitals and saved millions on treatments that are required due to delayed diagnosis.
If doctors want to keep paying customers they could reserve a few hours in the morning

RainyDay

coylemj wrote: »

Giving people free GP care sounds great but I used to work for a company where we had free access to a GP on two days a week. He operated from a room off the reception area so you could see the same people week in week out coming out with their prescription for an imaginary illness.

Can't have been much of a GP if he hasn't mastered the ability of saying 'No' to people with imaginary illnesses.

coylemj

RainyDay wrote: »

Can't have been much of a GP if he hasn't mastered the ability of saying 'No' to people with imaginary illnesses.

AFAIK doctors never say 'no', they just give the patient a 'prescription' for sugar pills - aka a placebo. The patient makes a full recovery every time.

ted1

RainyDay wrote: »

Can't have been much of a GP if he hasn't mastered the ability of saying 'No' to people with imaginary illnesses.

Good thing your not a Doctor, the placebo effect is very strong and sine people just need to chat.

RainyDay

coylemj wrote: »

AFAIK doctors never say 'no', they just give the patient a 'prescription' for sugar pills - aka a placebo. The patient makes a full recovery every time.

ted1 wrote: »

Good thing your not a Doctor, the placebo effect is very strong and sine people just need to chat.

I think you've been hanging around with the wrong doctors. Are you seriously suggesting that doctors are routeinely issuing prescriptions for sugar pills to avoid being honest with patients?

And as for those that 'need a chat' - I certainly recognise the importance of reaching out by people with mental health issues, but a 10 minute chat with a GP is not going to have any impact here. A chat with a GP is not counselling, and any half-decent GP knows this.

Boca

100gSoma wrote: »

I should disclose I have 2 kids under 3.
My local clinic is a conglomerate of 6 GPs. They have collectively decided not to sign up to the HSE under 6 GP contract.
One of the GPs explained that they would 'lose out financially so have decided to opt out'. Currently a visit costs €65 for my child. (I have two under 3).
So obviously it makes sense to change to a new GP who is signed up. It's just a real shame to have to move from a GP who knows our children and our family medical history and background etc and start from scratch with someone new.
I don't understand how they lose financially by signing up, because if I have to take my children elsewhere I certainly won't be going back myself or any member of our family. Surely that is a bigger loss? After years of paying 65 a visit, this feels like a big two fingers to their loyal clients.
Am I missing something? Ar they really losing that much financially?
edit: There are some other options of GPs who have signe dup in nearby villages. Deansgrange, Foxrock, Stepaside etc. but a couple I have tried stated 'their book was full' and are primarily signing up children of their current clients. that makes sense I suppose. anyone else in a similar situation? Any suggestions?

Out of interest did you manage to find a practice to accept your registrations? Having a similar issue myself

L1011

coylemj wrote: »

AFAIK doctors never say 'no', they just give the patient a 'prescription' for sugar pills - aka a placebo. The patient makes a full recovery every time.

This doesn't happen.

coylemj

coylemj wrote: »

AFAIK doctors never say 'no', they just give the patient a 'prescription' for sugar pills - aka a placebo. The patient makes a full recovery every time.

L1011 wrote: »

This doesn't happen.

Really?

BBC (2013): Most family doctors' have given a patient a placebo drug

In a poll, 97% of 783 GPs admitted that they had recommended a sugar pill or a treatment with no established efficacy for the ailment their patient came in with.

NY Times (2008): Half of Doctors Routinely Prescribe Placebos

Half of all American doctors responding to a nationwide survey say they regularly prescribe placebos to patients. The results trouble medical ethicists, who say more research is needed to determine whether doctors must deceive patients in order for placebos to work.

The study involved 679 internists and rheumatologists chosen randomly from a national list of such doctors. In response to three questions included as part of the larger survey, about half reported recommending placebos regularly. Surveys in Denmark, Israel, Britain, Sweden and New Zealand have found similar results.

L1011

coylemj wrote: »

Really?

Yes.

You can't "prescribe" a placebo in Ireland. Foreign stories are irrelevant here, and anyway - the BBC one in particular mentions ineffective meds, e.g. giving a whinger with a flu some antibiotics to shut them up. Actual meds, not effective for the illness. Not a placebo.

100gSoma

Boca wrote: »

Out of interest did you manage to find a practice to accept your registrations? Having a similar issue myself

Yeah, we went to Foxrock Village Clinic. Got both kids accepted there and it's quite close to Cabinteely park too.

Meredith

100gSoma wrote: »

Yeah, we went to Foxrock Village Clinic. Got both kids accepted there and it's quite close to Cabinteely park too.

I've registered here too as my gp is also in The Park Clinic. Brought my son there recently, nothing major, but wasn't impressed at all. I'm probably spoilt with The Park clinic as it is far superior overall. Anyone know if you can change doctors on the scheme? Although if my son ever got very sick I think I'd prefer to bring him to my gp who I know well and pay the fee, expensive as it is 😕

100gSoma

Im not sure if you can change GP because you are unimpressed. Maybe if you moved etc or had a valid reason.
As I've signed up here, I'd love to know what unimpressed you? The clinic itself or the standard of care you received?

The Park was very handy for us and we were happy there, but it's difficult to justify 65euro a visit when there is a 'free' option funded by your taxes.

Meredith

100gSoma wrote: »

Im not sure if you can change GP because you are unimpressed. Maybe if you moved etc or had a valid reason.
As I've signed up here, I'd love to know what unimpressed you? The clinic itself or the standard of care you received?

The Park was very handy for us and we were happy there, but it's difficult to justify 65euro a visit when there is a 'free' option funded by your taxes.

I know I shouldn't judge based on one visit only but I'd say I was in there for max 2 or 3 minutes. The doctor hardly checked his chest, he put the stethoscope on him very briefly (persistent cough for the last few months was reason for bringing him). He also didn't open a file, ask any questions about him etc. You can't make an appointment unless it's urgent, you just turn up and wait. I also spoke to a woman in the waiting room beforehand and she said you don't necessarily see the doctor you want, it's whoever's in the clinic on the day is who you see. On a lesser note, it's upstairs so you can't bring a buggy if you have a baby/small child. Just not what I'm used to and I continue to use my gp in the Park so it would be preferable to use the same one for my son also.

100gSoma

Oh!. They are completely fair enough reasons. Thanks for elaborating. No appointments and 'turn up and wait' doesn't usually go well with 2 children under 3 in tow. Plus it doesn't sound like he spent a lot of time(or any) asking about the history etc. I'd like to change myself perhaps.
HSE website is currently down so cannot find out about changing yet. There was a woman doctor in Deansgrange that was recommended so might try her if it's possible to change. I'll let you know if I find out any info.

uch

100gSoma wrote: »

There was a woman doctor in Deansgrange that was recommended so might try her if it's possible to change. I'll let you know if I find out any info.

There are 2 Lady doctors in Clem McCrory's surgery on Clonkeen Road who are lovely, but my kids preferred Clem himself, they thought he was "Nice & Funny"

coylemj

uch wrote: »

There are 2 Lady doctors in Clem McCrory's surgery on Clonkeen Road who are lovely, but my kids preferred Clem himself, they thought he was "Nice & Funny"

Two of the three doctors practising in the Deansgrange Medical Centre (used to be called Dr. Quigley's and on Clonkeen Road) are female, can't say how they interact with kids. It's on the corner of Kill Ave and Clonkeen Road, above the relocated Grange Pharmacy. The only caution I would express is there there is zero ventilation in the waiting room which is an internal room so there are no side windows - someone designed a doctors' waiting room with a large skylight which doesn't open and not a single air vent in the room!

Meredith

100gSoma wrote: »

Oh!. They are completely fair enough reasons. Thanks for elaborating. No appointments and 'turn up and wait' doesn't usually go well with 2 children under 3 in tow. Plus it doesn't sound like he spent a lot of time(or any) asking about the history etc. I'd like to change myself perhaps.
HSE website is currently down so cannot find out about changing yet. There was a woman doctor in Deansgrange that was recommended so might try her if it's possible to change. I'll let you know if I find out any info.

And the waiting room is small with one toy in it. At least in the Park the kids can be occupied in the little play area and be kept somewhat distracted. I went early and was waiting maybe 10 minutes but I was glad there was only one other person in there at the time as my son is flying around on all fours at the moment. If you were there with your two young kids and there were a few people waiting it could be hard going?!

I couldn't find any info about changing doctors either on the website, I emailed them but haven't heard back yet. I don't know if this would work but it's a pity for those whose gp's haven't signed up that parents could have the choice of paying the fee but then claiming it back from the HSE afterwards. Thankfully my son has never been very sick but if he ever is, I would be inclined to go to my own gp, peace of mind would be worth paying the fee.

100gSoma

Just a quick follow up. Went to Foxrock village practice recently with the children. Yes the waiting room is very small, and the stairs up to it very narrow, but we arrived at 9:05am and were seen second after about 10 minutes. Pleasant doctor, and was happy with the assessment and the visit in general.
Parking outside was not an issue either at that hour on a weekday. Pharmacy next door for prescriptions etc.
I will stick with them for the kids.
(I had to go to 'The Park' myself last week. 70euro for a ten minute visit. gasp )

Boca

Had a similar experience with our 1 year-old so I'll be sticking with Foxrock - it's an annoyance that we can't use our family medical centre (slievemore in stillorgan) as they had everything under one roof but forking out €65 for every little cough or cold would cost us a fortune