GPs MAY seek to revisit agreements on fee cuts for treating patients over 70 if the Government reneges on commitments to amend competition law, the Irish Medical Organisation (IMO) has warned.
It said agreements reached by the Government with the IMO regarding fee reductions were contingent on the competition legislation being amended.
It also said if necessary it was prepared to take the State to court over its right to negotiate on behalf of GPs on fees paid to them as contractors under the general medical services (GMS) scheme.
It has been the Government position that under competition legislation, it could not negotiate on fees with representative bodies for contractors such as GPs who provide services to the State.
The IMO wrote last week to Minister for Health James Reilly seeking confirmation that the Government would honour a pledge in the Croke Park agreement to change competition law.
In an interview with The Irish Times this month, Dr Reilly said a “form of words” had been received from the Competition Authority which would “allow enough cover for the likes of the IMO to be involved in discussions with the department [of Health] on terms and conditions”.
The Irish Times also reported that the chairman of the Competition Authority, Declan Purcell, had advised the Minister in August that the existing law should not in any way impede efforts to develop a new contract with the GPs.
“Competition law, among other things, protects you as Minister in your dealings with the IMO,” he said.
He spelled out for Dr Reilly what the IMO could do on behalf of its members when discussing a new GP contract. He said it could negotiate non-fee-related elements of the contract. It could also meet the Minister or officials to discuss an outline of fees and relay to its members the fees the State was willing to pay.
“The only requirement is that it is the Minister who ultimately makes the final decision on what the State will pay under the contract,” Mr Purcell said.
In his letter to the Minster, IMO chief executive George McNeice said the position of his organisation was that the GMS contract between GPs and the State was analogous to an employment relationship.
“The IMO does not accept that it is constrained or prohibited from dealing with fee-related issues in negotiations in connection with the GMS contract.
“The IMO is firmly of the view that, as the contract is analogous to an employment-type relationship, competition law has no bearing and as such the IMO is not fettered in its approach.
“The IMO is prepared to assert its right to negotiate in relation to the GMS contract and is prepared to assert this right, if necessary, through the courts.”
Mr McNeice said the Government gave a commitment in the Croke Park deal “to make appropriate changes to the Competition Act and a transformation agenda for GPs”. Given that the Competition Authority had sought to question the IMO’s rights to negotiate on behalf of GPs in relation to the GMS contract, a change in the legislation was needed “to remove any ambiguity”.
“In circumstances where the Government were to renege on its commitment to amend the Competition Act, the agreement of the IMO and its members secured [in connection with the reduction of fees paid for patients aged over 70] may need to be revisited.”