A draft plan of the VHI's primary care scheme which would entitle subscribers to recoup most of the cost of GP visits from the health insurance company has been rejected unanimously by the Irish Medical Organisation, which represents the vast majority of family doctors.
The organisation's GP committee turned down the plan, saying it would result in family doctors ending up with a fixed fee for doing an unlimited amount of work.
Dr James Reilly, chairman of the committee, said IMO members had suggested the VHI come up with one of three models of primary care cover: a modified capitation system under which GPs would have their annual fee per patient from the VHI supplemented if patients made several visits; a straightforward system whereby patients would pay their doctor and recoup the cost from the VHI; or a blend of both.
Further discussions between the VHI and the IMO are due to take place next week, and Dr Reilly said if a proper scheme was put in place it could be hugely beneficial to both patients and general practice.
"We are closer to formal negotiations than we were. As long as we are talking the possibility is there that something will come out of it," he said.
The VHI said yesterday it was confident it would be able to offer the public a primary care health insurance scheme from September.
At a press briefing, the VHI's chief executive, Mr Oliver Tattan, acknowledged that the plan had run into difficulties but said the VHI had learned much from its discussions with doctors. "There are still difficulties around who is taking the risk, what will happen the workload of GPs and what the visitation rates are going to be," he said.
The company, he added, was open to dialogue with all organisations representing doctors in an effort to make primary health care more accessible to all.
While the IMO represents 80 per cent of family doctors, the Association of General Practitioners (AGP), which represents the remaining 500 GPs in the State, plans to seek an interlocutory injunction against the VHI to prevent the new insurance scheme being introduced.
Full details of the scheme are still being worked out, but Mr Tattan said it was envisaged that patients who availed of the policy would still pay a fee when they visited their GP. The fee would be small to encourage people to avail of the insurance policy, but it would exist to ensure people went to the doctor only when they needed to.
Certain procedures offered by GPs such as skin biopsies and wart removal will be free to subscribers and the policy will be offered to everyone.
The annual cost of the plan, Mr Tattan said, would be different for different age groups but he considered an average plan would cost less than the hospital care plans now on offer from the VHI which average £300 a year.
While the plan will principally cover GP fees, it also proposes to cover a certain amount of dental and optical costs and some alternative medicines.