Under-6s and over-70s using free GP care may face ‘nominal fee’

Family doctors are to be given the option of charging patients a nominal fee when free GP care is introduced for under-6s and all over-70s next year.

The amount is likely to be about €5, the level of “co-payment” sought by the Department of Public Expenditure.

The Irish Medical Organisation (IMO) has strongly opposed the introduction of any co-payments as part of the scheme, but individual GPs who were surveyed in a recent study favoured their introduction as a way of discouraging inappropriate attendances.

Asked whether he favoured the imposition of charges, Minister for Health Leo Varadkar described the IMO research as convincing, but said he was also taking account of the views of GPs expressed in the survey.

“On that basis, GPs may be given an option to charge a nominal co-payment at their own discretion,” he said.

However, the money would go to the doctor's practice and not to the Health Service Executive, he said. "It would not be required to balance the books for the GP access scheme for under-6s and over-70s."

Almost two million people who access GP services because they hold a medical card or GP visit card will continue to be treated free.

Mr Varadkar is likely to come under strong pressure from the Department of Public Expenditure to impose a €5 co-payment.

The department, in internal documents on the health budget seen by The Irish Times, believes the introduction of such a charge is a "low-risk" strategy compared to other potential measures for raising revenue and cutting the deficit. The department predicts it could raise €5 million a year.

The introduction of the measure is dependent on the successful conclusion of talks on the proposal between the Department of Health and the IMO, which are continuing.

Former minister for health James Reilly announced the free GP care scheme for under-6s during last year's budget.

Responding to questions, he said free care at the point of use meant “free – full stop” with no hidden charges.

Earlier this year, his minister of state for primary care Alex White indicated that a charge could be introduced  for over-6s.

Mr White has since moved to become Minister for Communications.