Doctors’ Fees (Irish Times, 1904)

1.155, 290-91, 293-94. The Irish Times, (Dublin), Tuesday, 14 June, 1904, 6; Wednesday, 15 June, 1904, 8; Saturday, 18 June, 1904, 5.

Extracts from a series of letters in The Irish Times, relating to the fees of Irish doctors, referring both to pounds and guineas.

The professional habits of a medical student may well explain why Mulligan names a guinea at 1.155, just as it may explain why, at 290-91, he begins by naming a pound and then amends this to a guinea, then asks Stephen for a pound at 293-94, rather than any – on the face of it – more reasonable sum. On Tuesday the 14th of June, The Irish Times published a letter, dated the 8th of that month and signed simply ‘Householder’, on ‘The Medical Profession in Ireland’:

As a householder of many years standing, with large opportunities of observing the action of the average householder in cases of sickness, I can confidently assert that many lives are lost in Ireland through the reluctance to call in medical aid on account of the initial expense. To send for a doctor, with the certainty of having to give him a pound, whether the case be trivial or not, is what most people hesitate to do, and often hesitate too long, so that an illness, thought or hoped to be slight, has, when of a serious nature, time to make such headway as to be beyond medical skill when the doctor is eventually sent for.

Whereas, ‘Householder’ adds, the anxious English parent knows he will have to pay no more than 2s. and 6d. “or perhaps only 1s.” This drew two responses in the edition of the following day, one from ‘Observer’, agreeing with this voicing of a “real Irish grievance” and one from ‘One of the Profession’ attempting to refute the claims by referring the higher fees in Ireland to factors such as lower population density and the abuse of Dublin hospitals, intended for the poor, by the middle classes:

No doubt some years back the guinea fee was the usual one, at least the accepted one, and even till to-day a great many like “Householder” erroneously accept the situation as unchanged. But time works changes, and whilst no doubt what I might call the “old hands” in the profession, the reputed heads of the profession locally . . . who are to be regarded as consultants rather than as general practitioners in the usual sense of the term, still charge the old and higher fees, there are scores upon scores of other practitioners in Dublin and elsewhere who charge nothing like the fees alleged . . . the statement that “it has to be a pound and no less” (i.e. that £1 is the minimum fee) being quite untrue.

‘Householder’ then responded to this second letter on Saturday the 18th of June.

He [‘One of the Profession’] admits that “a great many” like myself believe the indispensable “guinea” fee to be still in force. May I ask him why they believe so? Is it from personal experience? . . . If no answer can be given to this, I maintain that my contention as to people hesitating to send for a doctor, in dread of “money-suckers (to use your correspondent’s word), is correct. . . .

Moreover, “Householder” points out, the likelihood of a consultant being called in by the general practitioner becomes greater because of the delay in calling on a doctor in the first place, for fear of the fee.

Then those “old hands,” when the “general practitioner” calls in one of them, and I ask my fellow householders if he does so often or not, the “old hand” closes not upon £1 or a guinea, but upon two guineas, and the distracted householder smiles outwardly and groans in his heart.