State may pay cost of some visits to doctors

Minister for Health Mary Harney is considering plans for a scheme in which the State would pay for tens of thousands of patients currently just above the financial threshold for a full medical card to see their family doctor as a private patient.

The move follows the breakdown in talks between health service managers and the Irish Medical Organisation (IMO) on the introduction of 200,000 new "doctor-only" cards.

These cards, which were first announced by the Government last November, would cover visits to GPs, but not the cost of drugs and medicines prescribed.

In a statement yesterday the Minister said that she was extremely disappointed that talks at the Labour Relations Commission had not succeeded in reaching an agreement on the introduction of the GP-only cards.

"I am anxious to proceed as soon as possible in order to ensure that families and individuals on low incomes can obtain treatment without charge. If the IMO won't co-operate with the scheme, then we will have to examine other alternatives.

"Accordingly, I have now asked officials in my department to urgently examine possible alternative arrangements for achieving the objectives behind the doctor visit card initiative", she said.

It is understood that the alternative under consideration would involve the State directly paying thousands of patients who are above the current medical card threshold for the cost of seeing their GP. Informed sources said that this could involve some form of voucher system, an annual advance payment to the individual or family, or the reimbursement of the cost of the visit by the health authorities on production of a receipt.

The breakdown of talks between the IMO and the health service managers on Wednesday night was the latest problem to beset the Government's plans for the GP-only cards.

Only last month the scheme seemed finally set to go ahead when GP members of the IMO voted to see patients with the new cards as part of an overall €93 million deal with the Health Service Executive on various outstanding issues, including the payment of benchmarking and other pay awards.

However, new problems quickly emerged over the interpretation of this agreement.

Both the Minister and the Health Service Executive- Employers' Agency yesterday accused the IMO of seeking to renegotiate the deal. The IMO has rejected this claim.

The health service managers said that the sticking point was over IMO demands for higher capitation payments for patients with the GP-only cards when they reached the age of 70 and qualified, under legislation, for a full medical card. The IMO said it was prepared to defer this issue but the HSE had wanted it to concede on the matter on the spot.