The majority of private hospital patients experience difficulties paying for medications and out-of-pocket expenses, according to the consultants who treat them.
While private patients enjoy better access to healthcare services, public patients have greater access to dietitians, social workers, speech and language therapists, and occupational therapists, a survey of hospital consultants shows.
Almost 65 per cent of private patients sometimes experience difficulties paying for drugs and other costs, while 17 per cent said this was a frequent occurrence, according to the survey of 244 members of the Royal College of Physicians of Ireland (RCPI). About half of the consultants surveyed said private patients, despite having insurance, experienced long waiting times to see a specialist and had difficulty getting specialised tests.
Pessimism
Consultants are not immune to the pessimism that pervades the health service, the survey indicates, with just 5 per cent saying the system works pretty well and needs only minor changes.
More than 80 per cent said there were some good things about the system but fundamental changes were needed, while 14 per cent said there was so much wrong with the system that it had to be completely rebuilt.
The research shows that consultants want to see a major shift in the way chronic diseases are managed and are calling for the development of shared services that are fully integrated within the healthcare system to care for patients in their local communities.
Some 97 per cent of those surveyed said they would welcome the concept of shared care services with GPs, nurses and hospitals to manage chronic diseases.
Before this can happen, a greater investment in information technology is needed to allow doctors, nurses and other healthcare providers to co-ordinate effectively.
Electronic records
The study shows that two- thirds of consultants do not use electronic patient records routinely, and only one-quarter keep a register to remind patients about appointments.
The results demonstrate that consultants and GPs believe the health system has to evolve beyond hospital-based care for patients with chronic diseases, said Prof Colm Bergin, dean of postgraduate training at the RCPI.
They are generally well disposed to the services being delivered by nurses working under the supervision of consultants or GPs, but they do not want them to be delivered independently by nurses.
Patients with chronic diseases such as diabetes, heart disease and chronic respiratory ailments account for 77 per cent of the overall disease burden in the State, according to the Department of Health.
