DOCTORS' FEES: THE GOVERNMENT faces potential legal difficulties under competition law in seeking to negotiate with the Irish Medical Organisation (IMO) on a new fee schedule for doctors operating the over-70s medical card scheme
The Department of Health confirmed last night that there had been contact at official level with the IMO in relation to the scheme.
No details were made available as to a timescale for the new "process" with the IMO announced by the Taoiseach on Friday, or when any meetings will take place.
The Government wants to renegotiate the terms of the scheme with the IMO to reduce the current €640 payment to doctors for looking after patients over 70 who received their medical card on age rather than means grounds.
However, over the last year Minister for Health Mary Harney has said legal advice to the Department of Health had identified significant competition and procurement law issues which prevented the State from entering into negotiations with representative bodies for self-employed professionals to develop contracts for services and to determine the associated fee arrangements.
Minister for Finance Brian Lenihan said on Saturday there was legal advice that the Health Service Executive (HSE) should not be engaging with various bodies on such fees.
However, he said the Government had taken a decision that there should be engagement given the gravity of the situation.
The Government's stance on negotiating with professional bodies in such cases has led to rows with pharmacists and dentists over the last year.
It has also considerably delayed the development of a new contract between the State and GPs, a key element of the Government's healthcare reform programme.
The IMO could not be contacted last night.
However, some sources said it was possible that the IMO could seek Government assurances that it would be able to negotiate in other areas such as the GP contract.
Ms Harney told The Irish Times in an interview last December that the State, through its agencies, could negotiate with representative bodies on the nature of contracts and the level of services to be provided by the groups concerned.
However, she said the State could not, under competition law, negotiate the price of such arrangements.
The Minister said under existing legislation the State could negotiate on price individually with each professional. However, with more than 2,000 GPs holding contracts with the State, this was not practical.
Ms Harney proposed that a new tariff-setting body be established to get around such restrictions. She suggested that the new body could be similar to the Review Body on Higher Remuneration in the Public Sector.
Ms Harney last year established an independent body to examine fees for pharmacists.
The Department of Health has declined to define the type of "process" envisaged by the Government to take place with the IMO in relation to the over-70s medical card.
