Free Haircare for All...

Imagine this scenario...

One morning in January 2014 the Irish Government announces that from July of this year, haircare for Under 6s will be free.......

Free Haircare for All By July 2014

Imagine this scenario...

One morning in January 2014 the Irish Government announces that from July of this year, haircare for Under 6s will be free. They have a draft contract that was produced in secret and without any consultation with the hairdressers of the nation, which they give to the Hairdressers Union after a brief meeting.

This contract makes no mention of how much the Government will pay but lays out in great detail all of the trichological services which now must be provided.

From July on, all urgent and non-urgent cuts, colours, treatments and blowdries, plus a new and unexplained, non evidence-based annual 'Healthy Hair Ireland' scalp & hair assessment, plus any other service, must be provided - without limitation - as demanded by the client.

For each of these consultations, the hairdresser will also have to prepare and submit a report. The hairdresser is forbidden from charging the public any fee for any service they request. The hairdresser must pay all their own expenses (staff, rent, heat/light, supplies, equipment, business, insurance, indemnity etc).

The Hair Service Executive will most definitely have no duties, responsibilities or obligations with regard to provision of haircare to all.

This pilot scheme is to be rolled out to Under 6's first but the Government announce their intention to make the same service available to all age groups regardless of haircare needs by 2016. Any hairdresser who signs this contract will be powerless to discuss different terms for adult clients and those with complex haircare needs in the future.

By signing up to this contract the hairdresser also agrees to provide 24/7 care either in the salon or in the clients home, as requested by the client.

The only mention of fees in the contract states that:

(i) Government will set the fee (because it would be anti-competitive to allow the hairdressers to be involved in negotiations on fees)

(ii) Government reserves the right to unilaterally amend this fee at any time in the future.

There is no acknowledgement that the hairdressers are struggling to keep their businesses viable since the Government made unilateral cuts of about 40% in the last few years due to FEMPI legislation. In addition, the Minister for Hair frequently tells lies in the media which overexaggerate hairdressers incomes by about 1000%, turning clients against their haircare providers.

What if the Government had decided to tell the media and public in advance that free haircare for all will be available by July, before they even made the draft contract public? The public would be encouraged to blame the hairdressers if there is a delay in getting free haircare, thus damaging the relationship further between service user and service provider.

Picture the scenes in the salon as clients demand to know why their hairdresser has not signed up to this contract and the hours of haircare lost as the salon tries to explain what is really going on.

Surveys will indicate that 95% of hairdressers are not prepared to sign this contract and take on the level of risk involved, even before fees have been mentioned.

If the Govt were to give say €1000 per client to provide this service, many would still not sign up to provide it due the level of risk in the demands made by the contract. There is also a gagging clause to ensure that no hairdresser would act as a whistle blower on behalf of their clients.

What if you told hairdressers that they would be paid as much as GPs to take on the contracts? Many might say yes, assuming that this would be an attractive package. Then say the remuneration could be in the region of €75 for a child under 6 per year, to cover all of the above, regardless of how many times that child may attend. For adults, the maximum payable may be about €150-200/year (which can be cut at any time in the future without negotiation)?? Current estimates suggest it might work out at about €14 per visit on average. That's not hairdresser take home pay, it's gross income before tax to cover business costs and staff income.

This sounds utterly ridiculous and it is supposed to.....except that this is exactly what the Government are trying to do to General Practice as I type this.

It's a poorly thought out political stunt.

The draft contract exists, the promise of free care to Under 6's exists, the threat of having Irish General Practice 'reformed' by the HSE exists, the farcical list of services that must be provided exists. They all apply to the future healthcare of you and your family, to your children and your elderly relatives. Practices are nearing non-viability due to the severity of FEMPI cuts and cannot take on this risk without resourcing and a proper plan.

To take on this new work as proposed and try to keep a viable business will involve:

  • Staff redundancies, including GPs (who are emigrating in numbers due to the current crisis)
  • GPs working 80-hour weeks to get the required paperwork done
  • Waiting lists of 2 weeks to see your stressed GP for 7 minutes as in the UK.
  • Your GP will be too busy writing reports and weighing children to treat you.

GPs deal with 98% of patient contacts, doing 24 million consultations per year, and get 2-3% of the HSE budget. 10% is recommended. The UK are in crisis and they have 8.4%. A commitment needs to be made to transfer 1% of the health budget per year from elsewhere to GPs for the next 5 years, along with transfer of hospital work to General Practice - where we do everything more efficiently (but can't do it for no money).

A proper plan is needed - one which actually involves negotiating with GPs rather than anonymous HSE managers in an office (who are out of touch with what we struggle to do on a daily basis).

This draft contract is insulting to GPs, expecting us to spend dozens of extra hours per week doing unnecessary paperwork and measuring of children which public or community health should be asked to do.

There is no acknowledgement of what we do to help our patients all day every day, spending longer than necessary with those who need it to try to keep them away from hospital with much of this extra work unresourced.

The Government needs a new contract more urgently than we do, due to foolish promises made that they can't keep.

The current system is broken but not so broken as to need a disastrous fix.

The relationship between HSE/Government and GPs has been injured possibly beyond repair, making an imminent solution very unlikely.

Irish General Practice is in crisis, and the future looks bleak. Sorry to be pessimistic.

Your TDs have been made aware, most of them are keen to try to educate Ministers Reilly and White that the current plan will not work as proposed. When your local TDs call to your door, please raise this issue with them.


  • Avatar-2
    Marie Scully said:
    Great article Sinead, needs to be sent out there again and again. Mind if I adapt for practice leaflet?
    Created: 25/04/2014
  • Avatar-2
    Ben Parmeter said:
    Well put Sinead. I think the authors of the draft contract and legislation have gotten a little confused and thought that the GPs were 'Under 6' and therefore they would get this one pass us. Ben
    Created: 24/04/2014
  • Avatar-2
    Chris Goodey said:
    Superb written Sinead - the tragedy is it is so true
    Created: 18/04/2014
  • Avatar-2
    Sandra Kavanagh said:
    Excellent article
    Created: 18/04/2014
  • Avatar-2
    Dr Stephen Murphy said:
    Sinead Great job in simplifying the crisis and dilemma facing GPs nationally. It is a blog that should be shared with the local and national media . What patients should see in this, is an effort by the HSE and Department of Health to damage the relationship GPs have developed with their patients. The primary goal is a political one and not a health one and that makes it more obscene. To damage an area of the Health service that functions effectively and is so well regarded by patients for indifferent or non existent health gains at the expense of sicker and more wanting patients is near criminal. Best wishes and thank you, Stephen
    Created: 18/04/2014
  • Avatar-2
    Brian Meade said:
    Terrific piece of work, I will put a link to this excellent analogy on our web site.
    Created: 17/04/2014
  • Avatar-2
    GBMC Editor said:
    @ Lorna On some levels, being an employee would be very attractive to doctors but at the expense of losing control over our businesses which currently ensure high quality care to patients without waiting lists. We fear that if the HSE took over the running of General Practice it would quickly become dysfunctional with lots of managers, spiraling (upwards, obviously) costs, less doctor/patient time and the sort of waiting lists that we have come to associate with our Hospital system... plus the country couldn't afford General Practice run by the HSE (watch the blog for more on this) Certainly the majority of GPs would make more money and have better job security if salaried but would quickly become demoralised working in a system that generates paperwork and unhappy patients. Dr Sinead Murphy
    Created: 17/04/2014
  • Avatar-2
    Nuala o Connor said:
    Excellent way to portray the reality GPs are facing so the public can try to understand. Could do similar for many other occupations ? Idea for media plan for IMO NAGP ICGP
    Created: 17/04/2014
  • Avatar-2
    Dr Gerard Murphy said:
    That article is both humorous and sad, humorous because it looks so implausible and sad because it is frighteningly true.
    Created: 16/04/2014
  • Avatar-2
    TH said:
    Excellent! I hope this gets a very wide readership! The best analogy I have seen. Send it to Minister Brendan Grace I mean James Reilly ASAP. (Hosp doctor)
    Created: 16/04/2014
  • Avatar-2
    Lorna said:
    Hi there, Interesting blog. In other countries, GPs are salaried members of the health service. What would you think of such an arrangement in an Irish context? Would it quell fears of mounting costs arising from the business side of the business? Would it be a consolation to be protected under employment legislation including the working time act? With thanks Lorna
    Created: 16/04/2014
  • Avatar-2
    JohnMcCormack said:
    Fair fecks to you Sinead. John.
    Created: 15/04/2014

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