FIGURES TO be published next month by the Health Service Executive will show that the State last year paid out close to €500 million in fees, grants and pension contributions to GPs operating the general medical services scheme (GMS).
However, while this is an area which has been subject to controversial Government cutbacks, further measures are under consideration to reducing expenditure.
About 2,000 family doctors receive fees under the GMS, which mainly relate to the operation of the medical card scheme.
However, while some medical practices receive very large amounts under the scheme, others are paid tiny sums.
The fact that for the first time one general practice received more than €1 million in fees last year – coming as it does after revelations that one pharmacy received €1.6 million – is likely to attract some attention. But at the same time nearly 40 received less than €1,000 and two received less than €50.
The Irish Medical Organisation has argued that the fees set out in the official figures do not relate to the income of individual doctors.
The organisation maintains that practice expenses – which run to 30-40 per cent – have to be deducted and that in the case of the higher-earning practices, the money may have to be shared among a number of GPs. However, the Government and the HSE are likely to argue that the GMS – involving as it does hundreds of millions of euro in fees and allowances to doctors and pharmacists – cannot be immune from the current review of overall expenditure.
Indeed, the recent McCarthy report proposed significant reforms in this area.
Ironically, the HSE is expected to examine the current system for providing care to patients with medical cards later this week as it draws up plans for the Department of Health on how to deal with possible cuts of up to €800 million in its budget for next year.
The McCarthy report proposed that existing contracts with GPs be phased out and future arrangements be put out to tender. This issue has been under consideration by the HSE in recent weeks as part of its plan for dealing with the anticipated budget cuts next year.
However, doctors contend that there have already been significant cutbacks in the GMS and that this is likely to be reflected in the cost of the scheme in future years.
Chairman of the IMO’s general practitioner committee Dr Ronan Boland said fees paid to GPs for medical card patients over 70 were effectively cut in half, while a further 8 per cent was cut from all State fees for GPs in March.