The Government is considering the establishment of a new independent body to recommend on fee scales for self-employed professionals, such as GPs, pharmacists and dentists, who provide services on contract to the State.
Minister for Health Mary Harney said she envisaged that the tariff-setting body would be established to get around restrictions under competition legislation which mean the State can no longer negotiate on fees with representative organisations.
Ms Harney said the proposed body could be similar to the Review Body on Higher Remuneration in the Public Sector, which makes recommendations to the Government on top-level pay in the public sector.
The Government has argued that legal advice 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.
Ministers have maintained that these matters are governed by both EU and national competition law.
This stance has led to rows with pharmacists and dentists and has delayed the development of a new contract between the State and GPs, a key element of the Government's overall healthcare reform programme.
Ms Harney told The Irish Timesthat the State, through its agencies, can 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.
She said that, under existing legislation, the State could negotiate on price individually with each professional. However, with more than 2,000 GPs and 1,600 pharmacists holding contracts with the State, she said this was not practical.
"What I envisage is the State, through the HSE [Health Service Executive] and the Department of Health, negotiating the nature of contract it wants with the self-employed professional," she said.
"And then an independent group, like the higher review group on public sector pay, would make a recommendation on the price that should be paid for that contract."
The Minister said that, based on legal advice to the Government, "this is the future for self-employed professionals".
She added that, in areas such as pharmacy and the medical card scheme, the State was in a dominant position. "It is not like other countries where you have several service providers separately negotiating," said Ms Harney.
"The State is in a very dominant position and has to ensure that in that dominant position there is objectivity and fairness in the manner in which it sets about determining what a fair return is for the service or contract."
In the run-up to Christmas the Labour Party sought to amend the Competition Act in the Dáil with a view to allowing the State to negotiate with representative bodies for pharmacists and other affected groups.
However, Ms Harney said she believed that it would not be a good thing to change the legislation.
"These provisions are there to protect consumers and there is an EU-wide dimension as well as a domestic dimension," she said.
