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Our View: HIO move will only serve to encourage abuse of Gesy

A&E departments are already under strain

It appears the Health Insurance Organisation (HIO) is so flush with cash, thanks to the monthly contributions it has been collecting from individuals and employers, it feels the need to find ways of spending it. No thought is given to the possibility that when the national health scheme (Gesy) enters its second phase next year that will cover operations and hospital stays there could be a greater demand on funds and it would be wise to have surpluses put aside for when costs will soar and contributions might not be enough to cover them.

It would make more sense to be cautious on spending now until the full scheme is in operation and if there are still surpluses to improve the primary care service. Under the circumstances, the latest service that will be offered seems wastefully unnecessary. HIO has invited personal doctors and paediatricians to apply for posts as duty doctors both on weekdays and weekends. They would offer services from 7.30pm to 10pm on weekdays, 9am to 5pm on Saturdays and 9am to 1pm on Sundays.

Having duty doctors working after 7.30pm on weekdays is ludicrous. If someone is so ill they need to see a doctor during those times they could go to the A&E department of a hospital, but most illnesses can wait until the next day. Is the HIO now going to pay doctors to examine people with a sore throat or stomach upset at 9pm when they can wait until the next day? Having on call personal doctors on a Saturday may be justifiable, although a patient now has the option of paying €25 to see a doctor on this day, but on a Sunday there is no need.

A few weeks ago, a Gesy manager said that people needed to be educated about free healthcare so they would not abuse the scheme and place it under unnecessary pressure. However, the HIO policy encourages this abuse, because its policy is to offer patients everything they demand, regardless of the cost. It could be said that the additional cost of having duty doctors, afterhours and at weekends, would be small, but the reality is it encourages abuse of the system, which has to be actively discouraged.

The HIO mentality of spending freely to please patients and receive plaudits from the media is wrong because there will come a time when it will be short of funds and might have to cut unnecessary services. The overriding priority of the HIO and the health ministry must be a sustainable Gesy because a Gesy that aims to satisfy all patient demands will eventually run out of funds.

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