Caroline Spillane, Medical Council CEO
The Medical Council is to consider a specific reference to price display by GPs in its next Ethical Guide, reports Dara Gantly.
The Medical Council is to consider specifically addressing the display of professional fees by GPs in the programme for revision of the Council’s Ethical Guide, Irish Medical Times has learned.
Council CEO Caroline Spillane informed Minister for Health Dr James Reilly earlier this summer that, given the “importance of the issue”, the matter should be considered for inclusion in the programme for revision of the Council’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners.
Minister Reilly had written to the CEO in March in support of a request by the National Consumer Agency (NCA) that the Council include a specific reference to price display by GPs in its professional standards and guidelines.
The Minister told Spillane — in correspondence seen by Irish Medical Times — that he believed people should know what costs they would be incurring when they visited a GP’s surgery, and that this should be a “requirement” in the Council’s professional standards and guidelines.
Last March, the NCA wrote to the Medical Council on the issue, as a follow-up to previous correspondence and meetings subsequent to a study by the Agency, conducted in March 2010, which examined levels of price display and fee levels charged for a short list of routine services in relation to both GPs and dentists. That study found that just 50 per cent of GPs nationally displayed their consultation fees.
It is understood that the Council at the time advised the Agency that it would be appropriate for it to first discuss and agree a schedule of fees suitable for price display with the GP representative bodies before reverting to Kingram House. The NCA did just that, and last November the IMO advised its members to introduce price lists for routine medical treatments, such as a normal hours consultations, home visits, or nurse consultations, commencing from December 1, 2011.
However, the NCA noted in its first letter to the Medical Council’s CEO last March that the recommendation remained a voluntary one, and that — given the comments made by Minister Reilly during the Committee Stage debate on the Health (Provision of General Practitioners Services) Bill 2001 last December supporting the move — the Council should now amend the Ethical Guide to include such a provision.
“You will be aware that the Dental Council, in conjunction with the NCA, agreed a standardised format of price display for dentists in April 2011. This took effect as a regulatory requirement as part of their Code of Practice on 1 June 2011,” NCA Chief Executive Ann Fitzgerald informed Spillane.
Initially, it would appear that the Council felt the matter was already addressed in the current Guide. Spillane responded to the NCA Chief Executive in mid-March, indicating that the Agency’s request had been considered by the Council at its previous meeting. “The Council is of the view that the requirement to provide patients with information in relation to costs associated with treatment is clearly set out in the current Guide to Professional Conduct and Ethics for Registered Medical Practitioners, in paragraph 54.1 and 54.3,” the Council CEO wrote.
Public interest
While paragraph 54.1 refers to the provision of factually accurate information about the availability of medical services being “in the public interest”, paragraph 54.3 specifically states: “The fees you charge should be appropriate to the service provided. Patients should be informed of the likely costs before the consultation and treatment.”
However, the National Consumer Agency believed these provisions had not done enough to increase price transparency for consumers, and did not specifically address the issue of price display.
It also noted in subsequent correspondence with the Council’s CEO that paragraph 54.3, or a slightly different wording in the previous Guide, had been in effect since 2004, and its survey of 2010 had shown that half of all GPs still did not display such pricings.
“The Agency understood, from our discussions in 2010, that the Council was of the view that we should progress our initiative with the representative bodies in the sector and then revert to the Medical Council, once an agreement had been reached. The Council would then take steps to ensure that any agreement was implemented,” added Fitzgerald.
Later that month — on March 27 — Minister Reilly wrote to the Medical Council in support of the request. “I am pleased that the Irish Medical Organisation has recommended to its members that they display price lists for routine procedures, but I believe that this should also be included as a requirement in the Council’s professional standards and guidelines,” the Minister stated, in correspondence seen by IMT.
Consultants
In the letter — obtained through the Freedom of Information Act — the Minister went even further in stating that the Council should also provide for the display of private fees by consultants.
Following both further correspondence from the NCA and the Minister for Health, the Council indicated that the issue would be discussed again by Council at its next meeting on April 25.
According to minutes of that meeting, it was agreed that the CEO would write to both the NCA and the Minister advising that the Council would take this under consideration for the next edition of the Ethical Guide.
In recent weeks, the Council published guidance clarifying its position on the relationships between doctors and industry, in the form of ‘frequently asked questions’ that stipulate the standards expected of doctors in their dealings with the pharmaceutical and medical device industries.
The Council has also pledged to develop further guidelines relating to assisted human reproduction.
About Dara Gantly
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