Oireachtas Joint and Select Committees

Wednesday, 28 September 2016

Select Committee on the Future of Healthcare

Management of Chronic Care Illness: Discussion

9:00 am

Photo of Kate O'ConnellKate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

I thank Dr. Murphy for his presentation and wish him well with his new practice. He is brave. He referred to patients with multiple illnesses. When we met Dr. Fawsitt last week, I believe Professor Susan Smith spoke about the capitation rate for GMS patients and suggested having an increased rate for more complex patients. Obviously, a straightforward seven year old who has nothing wrong is one sort of patient, but then there is the diabetic with high blood pressure, missing a foot and various other things. Are there any suggestions for how GPs would get paid relative to the complexity of illness of the patient in order that they get paid properly? A GP might spend 30 minutes with a very complex patient and can get somebody else through in three minutes. From last week's discussions I was inclined towards two different pay scales. However, from what I have heard today, I feel that there is a vast difference between somebody with nine things wrong and someone with three things wrong. How would the witnesses like to see that happen?

I mentioned this to Professor Susan Smith when she appeared before the committee. I may be wrong in this. I am a pharmacist. When a patient is worth more financially to a doctor, is there a risk that GP groups would want the sicker patients because the headage payment is better? There might be a concentration of people with a huge amount of illnesses in one practice. Would that be a good thing or would it be better for GPs to see a cross-section of society in order to keep up to date? Is it better to have all the very sick people in one place or all spread out? What is the optimum? I do not want very sick people to be used as a commodity.

Nobody mentioned community pharmacists as part of the primary care team.

Comments

No comments

Log in or join to post a public comment.