Dáil Éireann Debate, Thursday - 24 February 2005
9 Mr. Gogarty asked the Minister for Enterprise, Trade and Employment if it will be possible for him to issue regulations requiring the public display of doctors’ and dentists’ prices; and if he will make a statement on the matter. [6220/05]
View answer17 Mr. O’Shea asked the Minister for Enterprise, Trade and Employment the reason it has been decided not to proceed with the promised order under the Consumer Affairs Act to require doctors, dentists and allied health professionals publicly to display their prices; the steps he proposes to take to ensure that patients are aware of the basic charges levied by doctors and dentists; and if he will make a statement on the matter. [6158/05]
View answer54 Mr. P. McGrath asked the Minister for Enterprise, Trade and Employment the communication his Department had with the Department of Health and Children regarding plans to instruct doctors and dentists to display price lists; the nature of that correspondence; and if he will make a statement on the matter. [6208/05]
View answerI propose to take Questions Nos. 9, 17 and 54 together.
On 16 December 2004 in reply to a parliamentary question I announced that I had decided not to proceed with the making of an order under the Prices Acts 1958 to 1972 to oblige doctors and dentists to display their charges. The reasons were both legal and practical. In particular, as a result of legal advice on the matter I had formed the view that it would not be possible to effectively enforce the display order for doctors and dentists and that making such an order would consequently not be appropriate. In the deliberations on this issue the Department of Health and Children was consulted and informed of the possible contents of an order. That Department had no objections to the making of an order. It supplied my officials with some suggestions as to items to be covered by the order but these did not affect my final decision.
I cannot see any way around the enforcement problems identified. However, the two professions can introduce measures under their own codes of practice to provide greater price transparency to patients. I did not want to introduce a scheme, as it would result in higher charges for patients.
Two weeks ago a newspaper quoted a Department official as saying the Department had been "outfoxed", to use the word contained in an internal memorandum, by the medical and dental professions. The long list of services that would have to be covered became a de facto way of nobbling the idea. The dental profession suggesting that a filling should not be covered was another outfoxing manoeuvre. How does the Minister respond to the publication of the comment from within his Department that it had been outfoxed by the professions?
Why does the Minister believe it would result in higher charges when the Competition Authority, the Director of Consumer Affairs and many others believe it would be a service to customers and possibly through the introduction of a slightly more competitive environment would lead to a reduction in prices?
The legal issues are very real and the most problematic would relate to data protection. We need to consider the practical implications. To check if patients had been charged no more than the price displayed, an inspector would need access to the patient records, which could not be done without the patients' consent. Whereas inspectors could seek consent, practical problems would arise. Would inspectors loiter in surgeries' waiting rooms and approach patients asking them the procedures they had received and then check the price charged against the display?
Has the Minister read the IMO submission?
Alternatively would inspectors wait outside surgeries and ask patients to divulge their details? Neither of these scenarios offers a viable basis for enforcing any price display order.
The Minister should read the IMO submission.
The number of procedures and tests a patient can receive is increasing all the time. There is a generic charge for people seeing a doctor and they have an expectation as to what they will be charged. Some of the lists that emerged did not enthuse me. I am entirely pro-consumer and I am satisfied I took the right decision in the interests of the consumer.
This first came to light in response to a parliamentary question I tabled. The Tánaiste announced this with great fanfare more than a year and a half ago and it was to be implemented in weeks. Following a meeting with the Department of Enterprise, Trade and Employment, an IMO spokesperson said that Department officials had pointed out logistical problems, which I have now heard rehashed. It is extraordinary that while we can have price lists for hairdressers and others, certain groups are untouchable. We surely can have a mechanism whereby we require the display of prices and while inspection might not take place we could certainly investigate complaints from patients who advise they were charged more than the displayed price. Why can this not be done? Without it we have no basis for real competition in certain sectors. We will have a competitive economy with no-go areas.
Prices can be displayed in various ways. The use of the Internet is now widespread among businesses and faculties and it would be capable of providing a longer list. Practices have certain basic core services, particularly for a regular visit not involving any procedures. The public display of those charges would not require an inspector hovering over patients in case they were overcharged. It would increase the access to simple basic information. I cannot believe it is beyond the powers of the Department and the relevant professional bodies to agree certain of those simple procedures that nobody could dispute had been carried out.
I would argue to the contrary. It is not as simple as has been suggested. When I saw the file, I decided I could not preside over introducing a scheme that could result in a €200 charge instead of a €50 charge. Deputy Howlin, who was Minister for Health for two and a half years, has as much experience of the concerns we are discussing as I have. The Deputy is laughing in acknowledgement. Can he tell me any scheme that was ever devised where the costs and inputs did not increase?
We are talking about transparency.
The Deputy should read my lips on this matter. Having reflected on the matter completely, it is better for the consumer not to go down this road. The legal issues are real in terms of doctor-patient confidentiality.
With cryptic messages between former Ministers for Health it is very difficult for the layman to understand what the Minister is talking about.
This former Minister does not understand.
