GP fees are bad for your health, says EU

The Government is under pressure to remove the prescription drugs charge and avoid new GP fees after an EU report found such costs can damage people’s health and do not save the system money.

The European Union’s expert panel on effective ways of investing in health said that the policies are “inequitable”, fail to fill holes in health budgets, and can have a “negative effect on health”.

In a major public discussion document, the group said that, in spite of the theory that various primary care fees bring in vital funds and discourage the ‘worried well’ from attending, in reality the fees cause patients to avoid being treated until an illness worsens and then becomes more complex.

The EU panel said the policies — which are in place in a number of European countries, including Ireland — may not benefit the public or offer any real financial help to the system itself.

The panel said the reasons used to justify user charges include: Raising revenue for the health system; reducing ‘unnecessary’ demand for health services or to direct people to more cost-effective services or patterns of use. However, the report rejects these reasons, stating:

- As a means of raising revenue, the charges are both inequitable and inefficient in comparison to pooled funding;

- As a means of moderating demand, the charges are constrained by the fact they do not have a selective effect between necessary and unnecessary treatment;

- Charges reduce use of low and high-value health services in almost equal measure;

- Applying user charges across the board is likely to deter people from using appropriate care, even where charges are low. This undermines financial protection and can have a negative effect on health.

When the prescription charges were first introduced here in 2010, it cost 50c per item for medical card holders. It now costs €2.50 per item to a maximum of €25 per month.

The report said user charges, such as those for “obtaining prescription drugs in primary care”, merely “shift” patients to non-charge areas like hospitals “which is often more expensive” for the system.

It also said there is “little evidence” to suggest the fees “lead to more appropriate use or contain public spending on health care”.

The Irish Medical Organisation called for existing charges to be removed and for the future free GP care plan not to be funded through hidden fees.

“The IMO has long called for the reversal of prescription charges as we can see evidence on a daily basis that patients are not complying with the advice of their doctors in terms of medication due to financial constraints,” said IMO president Ray Walley.

A spokesman for Health Minister Leo Varadkar said the issue is part of “ongoing” talks with doctors over potential changes to the primary care funding system.

However, he stressed that some doctors are in favour of “co-payment” fees.

“When making submissions, many GPs asked that there be co-payments to discourage inappropriate visits [to GPs]. The minister is meeting with the IMO in September and will be happy to discuss it further,” said the spokesman.