Doctors will 'not allow' free care without extra support

IRISH MEDICAL ORGANISATION CONFERENCE:THE IRISH Medical Organisation has warned that GPs will not agree to the Government's plans for free medical care to all patients with long-term illnesses unless increased resources and financial supports are made available.

The provision of GP care to about 56,000 patients who currently receive free medicines and drugs under the long-term illness scheme, planned for this year, is one of the first key steps towards the introduction of universal healthcare.

However in a hard-hitting address to the annual conference yesterday IMO chief executive George McNeice said while there was a compelling case to use the GP service for long-term illness management, “we won’t be party to a solution which forces additional work on to an over-stretched service without proper resources and financial supports being made available to ensure it works properly”.

“Allowing that to happen would be bad for our members . . . but it would also be bad for our patients and we won’t allow it.”

“As a former president of this organisation, I have no doubt that [Minister for Health] James Reilly knows this – and I hope he knows too how determined we are on this and other issues.” The chairwoman of the IMO’s GP committee Dr Mary Gray said last night that the current general medical services contract between doctors and the Government involved eligibility for services being based around means rather than on specific illnesses.

She said there would have to be negotiations with GPs on the Government’s plans to extend free care. She said additional resources would be required to allow for the provision of doctors, nurses, infrastructure and secretarial support. She said at this stage it was unclear as to how the additional resources could be provided, whether it be through higher capitation rates or some performance-related pay elements. She suggested as workloads transferred from other parts of the health service into primary care, budgets could also be moved.

In his address Mr McNeice said the optimism and enthusiasm that had greeted the election of the Government a year ago and the appointment of Dr Reilly as Minister for Health had all but disappeared. He said a year on problems in the health service had not been solved and “there is little confidence that the right progress is being made”.

Mr McNeice said in opposition members of the current Government never tired of speaking about the deterioration in the health service and the need for a radical overhaul.

“Some people, including some who should have known better, held out the prospect of easily implementable reforms transforming the patient experience.”

He said that in Government the promise of these reforms had become bogged down in the carpets of the Department of Health.

Mr McNeice said the Mandarins “who have spent years defending the indefensible and formenting division and tension are winning the key arguments and we are stuck in crisis management when what we need is crisis resolution”.

He said the over-riding impression now was of how little had changed since the new Government had come into power, not how much.

Mr McNeice said that while the IMO supported the concept of universal health insurance, the Dutch model of healthcare which had been heavily promoted by the Government needed “much closer examination before we can truly say whether it is a suitable model to import into Ireland”.

The IMO chief executive said both tiers of the Irish two-tier health service now appeared to be in danger of collapse and he criticised “chaos and mismanagement” seen in the health service over the last 12 months. He said this included “the farce over the administration of the medical card system where tens of thousands of applications got stuck in a jam that is taking months to resolve”.

He said the Department of Health had created a revolving door in relation to non-consultant hospital doctor posts. He said the department was chaotically trying to fill positions in hospitals which had been vacated by Irish graduates who had been forced to emigrate as a result of its policies.

Mr McNeice said the Government was in danger of killing the golden goose that was the GP service.