Analysis: Free GP care plan faces many hurdles

The memorandum of understanding reached between health service management and the Irish Medical Organisation (IMO) on a new GP contract is an important development but does not guarantee the successful introduction of free family doctor care.

There are still major hurdles before the Government’s plan for free GP care for everyone is implemented.

The Government intends to put free GP care in place in stages, starting with children under six and people over 70.

However, there is a general acceptance a revised overall contract covering general practice schemes is needed, into which the under-sixes arrangement would eventually be absorbed.

The new memorandum provides an outline of the scope for the negotiations on such an overall contract. It proposes talks would get under way at the end of March and be finished within a year.

This puts considerable pressure on the Department of Health and the IMO to conclude talks within the next few weeks on a contract for children under six and on the fees to apply.

Importantly, the Government has agreed a process aimed at reversing some of the cuts imposed on GPs since the onset of recession. The IMO has estimated resources to GPs have been cut by about €160 million since 2009.

This process, likely to run in parallel with talks on restoring public service pay levels, may act as a sweetener to encourage GPs to back the Government’s reform plans.

Any contract on free care for children under six will have to be sent out to family doctors individually. The IMO can express its views but, under an arrangement with the Competition Authority, it cannot make a recommendation or organise a collective response, such as a boycott.

Second body

However, a second GP representative body, the National Association of General Practitioners, which has not been involved in the talks with the Government, has called on its members not to sign up to the free GP care plan. This means free care may not be available everywhere across the country.

There are also differences on any subsequent expansion of the free GP care plan. The Government wants to roll out the initiative to older children in the next phase. Instead, the IMO believes qualifying income thresholds should be increased and free care provided to patients with chronic diseases.