The agreements reached between the Irish Medical Organisation, the Department of Health and the Competition Authority should facilitate talks on developments in general practice which have been delayed for nearly a decade.
They could allow for the convening of substantive talks between the Government and the doctors’ trade union on its controversial plans for the introduction of free GP care for children under the age of six.
However, there is no unanimity among GPs about the benefits or otherwise of the agreements reached yesterday.
The IMO argued yesterday’s developments were “highly significant” and provided a framework and acknowledged its rights to engage with the Minister for Health and/or the Health Service Executive.
However, a rival organisation, the National Association of General Practitioners, said it was appalled at the terms of the agreements reached by the IMO with the Competition Authority and the department.
Contract update
Since 2006 there has been little or no progress in updating the State’s contract with GPs for services under the General Medical Services scheme and other schemes which virtually all sides agree is necessary.
The hold-up has been due in part to the view of the current Government and its predecessor that, under competition law, it cannot negotiate directly with the IMO on behalf of its GP members in relation to fees.
GPs, unlike other categories of doctors such as hospital consultants, non-consultant hospital doctors or those who specialise in public health, are not employees of the health service but rather are independent contractors.
Antagonism of doctors
The antagonism on the part of family doctors to the Government’s plan to introduce free GP care for children under age six stemmed in part from the insistence of the department that it could not negotiate with the IMO on the payments to apply under the proposed scheme.
The deal reached between the IMO and the department, following “talks about talks” over the last fortnight or so, will give the doctors’ trade union rights to engage with the Minster for Health/HSE on the scope and content of any changes and reforms proposed to the State’s publicly funded general practice schemes.
The IMO can also engage with the Minister/HSE in relation to the resources being provided for such developments as well as the fees that would apply.
IMO opinions
The IMO can also express its opinions to members on the outcome of any such talks.
However, it cannot make a recommendation to members on the issue and must advise them that they have to make up their minds individually and not collectively.
Under the agreement, the IMO cannot organise a collective response by GPs such as withdrawal of services or boycotts of schemes.
The agreement also stipulates that while there can be third-party arbitration over any dispute on fees or other aspects, the setting of the fees remains a matter for the Minister.
Nuclear option
In other words, the IMO can enter into talks on behalf of GPs in relation to fees and other matters, but it cannot exercise the “nuclear option” available to trade unions of organising a withdrawal of labour if a dispute is not resolved.