The current level of costs definitely affects those who attend accident and emergency services and the College of General Practitioners supports that claim, as do the accident and emergency consultants. It costs €40 to attend accident and emergency departments and it costs probably less to visit GPs, some of whom charge about €25. However, a large proportion of people do not pay in accident and emergency departments. It is much easier to refuse to pay the anonymous receptionist who has the misfortune of trying to collect the money or the strange doctor whom one is unlikely to see again than one's own GP, whose receptionist may be a neighbour. There is also a problem with people giving false names and addresses in accident and emergency departments when they cannot pay so that they cannot be traced. This is a serious issue which needs to be addressed.