DPS Vs Medical Card

[cancer]

Went to see one of my consultants privately last week. Consultant works in an acute hospital as both a private and public consultant. Had seen same consultant publicly about 3 week previous but I was 3 hours and 10 minutes waiting, 2 hours 40 minutes after my appointment time. Had enough of that and told him so. Bloody exhausted from sitting when I met him. Told him could not and should not have to do that again - He agreed. I wasn't the worst public patient seeing him but I was the last of the day. Anyways seeing consultant privately cost me €100 - €42 back on tax. Anyways it went well and I got a prescription. Approx 15 minute wait after appointment time to see him privately in same hospital grounds. (Consultants refused Mary Harney and HSEs demands that new consultants be either public or private ONLY and with no public backing consultants won that battle as well) Dropped into the chemist on the way home and asked them to add prescription to my file so I can collect the meds as and when I need them. Usually one visit and get them all out of the way. I even know where my chemists kids holiday - to much personal knowledge of some professionals is a bad sign.

Called to the chemist today to draw down meds for myself and my wife - kids are off to Vegas today next year! . Wifes meds were in excess of €90 under DPS scheme. I have a medical card. Special dispensation while I have cancer. Anyways because my prescription came from a private consultancy I was told I have to go into my GP to get a prescription from them. Private consultant prescription was not acceptable.

Think about that.

Having seen a consultant who practices publicly and privately in a public hospital and having received a prescription for required medicines I needed to go to my local GP (surely a lower level private health practitioner) and get the same prescription again because 'dems the rules'.

Cost implications:

My time. Sick patients spend enough time seeing consultants, doctors and hospitals why add to this.
Taking time from GP who has other patients to see - why add to the queue in GP surgeries / why double up the work - need to have the prescription written twice!
Additional cost to the Health budget for seeing GP for free on medical card

BLOODY stupid BUREAUCRACY - there's more

I suggested that as my wife is on the DPS and we were a family could I buy my meds under the DPS. It would not cost any way either for me or the HSE and it would save the cost of the GP visit both for me and the HSE. Free under DPS Vs free under medical card. Shouldbe an easy concept to grasp. They agreed to give me one med as a once off and it was the Bank holiday - plus they could I was not happy with this crap! They said I had to go to the GP and get the prescription. Had I been a normal customer I could have called down a few months supply of the prescription but not with the medical card.

Moving back in time I had words with my GP a few weeks back over the fact that she was only allocating meds on a monthly basis rather than half yearly which saves me having to call regularly for the same prescription which is the same as I have had since being a teenager. Half yearly is what I am used to. Anyways she agreed to give me a monthly prescription for 3 months by way of compromise and I sold it like that to the chemist. That was as far as she could go on the medical card under 'dem rules'. I presume it is to stop abuse but the HSE pays her the cost of my GP visit every month when I visit; and all she does is write the same prescription. On the DPS a prescription can last 6 months, if you know the chemist well sometimes longer.

One other example springs to mind. A few years back when my wife collected about 4 bags of meds and a few boxes - seriously costly stuff. I kid you not. I had 2 pages of an excel spreasheed of all the meds I was to take. I wanted out of hospital so we went and collected about 2 months worth of stuff. When herself is reviewing the list of meds against the prescription she finds 2 meds missing. I was on a medical card at the time. She went back to the chemist who said they weren't covered under the medical card. DISGRACE. The chemist informed her that people normally won't pay for medicines not covered by the medical card, even if prescribed. She said it embarrassed some people when they mentioned it so they didn't. One of the meds was for temperature control. We spotted it missing when my temperature almost reached the point where I would need to go back to hospital! Why aren't all prescribed medicines covered under the medical card. DISGRACE. My wife offered to pay, some of the cost was over the DPS limit of €85 at the time so max cost was €85.

My point here is simply put (though long-winded) - WHY IS IT SO MUCH EASIER TO BUY MEDS ON THE DPS SCHEME AND SO BLOODY AWKWARD WITH THE MEDICAL CARD?

[Petrus]

Short Answer
DPS has a co-payment = you pay
GMS Government pays.

Long answer
To address some of the points you have raised.
When you get a GMS card the HSE will cancel your DPS card after a number of months. The pharmacists was probably worried that they may not get paid for the medication they gave you.
There is a scheme called the Hospital Emergency Scheme where a patient with a hospital prescription written in the last 24 hours can get up to a weeks supply of approved medicines from the pharmacy without visiting their GP. The HSE issue a list of approved hospitals, the prescription must be written on one of their pads or the HSE won't pay for the medicines. If your consultant wrote the prescription on a public hospital pad, you could have gotten a weeks supply.

YES, it is madness, complete madness. The regulations have not been revisited for over a decade.

As an aside, pharmacists get paid for dispensing or selling medicines. If they won't supply you with a prescription or sell you medication, they are refusing work. Refusing an opportunity to make money. Think about that.

Reasons:
Inappropriate, unsuitable, unsafe etc
Or in the current climate the HSE won't pay for the medication.
'dems' the rules and if the pharmacist doesn't dot every 'i' and cross every 't', they don't get paid.

Again, I agree it is bloody stupid bureaucracy.

GP's have 2 forms to write GMS prescriptions on, a single months prescription (one months supply) or a 3 month prescription (3 installments of one months supply). They can't write a 6 month prescription, but they could write 6x1 months or 2x3 months, it is unusual for them to do that, but they can. ( a single, 3x single or 1x 3 month are normal)

The HSE has a list of approved medicines, if a med has a GMS code, a pharmacy gets paid for it.
If it doesn't, you don't, black and white. Some medications are not allowed on the Medical card but should be.
Madness economically and a disgrace socially.

However if you are prescribed something and not given it, you should have been told, that was a mistake.

The HSE seem to put barriers in place to you accessing expensive services. New and interesting ways of justifying a job by getting health care professionals to fill in forms that are meaningless.
If they put enough hoops in the way that you must jump through, a lot of people don't bother and go away.

They complain about demand led schemes which are cheaper in the community than hospital, that stop people from being admitted to hospital.
Illness leads the demand not economics.
Funny country we live in.