The representative body for general practitioners has said it is concerned at the slow progress of primary care development, one of the key elements of the HSE's overhaul of the health service.
The Irish College of General Practitioners (ICGP) also said that family doctors were concerned at the lack of understanding of the role of the GP shown by the HSE during discussions on the development of primary care services.
Following representations by individual members, the ICGP issued a statement in which it outlined its worries at recent events.
The Irish Timesunderstands that it was only in the past 10 days that the HSE formally met ICGP representatives at a national level to discuss the development of primary care.
But at local meetings, GPs are alarmed at the lack of understanding shown by local administrators, in particular of the confidential nature of the GP/patient relationship.
"The discussion to date has taken place predominantly at local level and there is a perceived lack of direction and discussion at national level. If change is to be implemented in a concerted, rational manner, a process for discussion must be devised at national level," the ICGP said.
Asked to clarify whether the general practitioner body was rejecting the health service's primary care plans, ICGP chairman Dr Mark Walsh said this was not the case. "Our criticism is that the primary care strategy is not being implemented."
But referring to plans announced in 2006 to roll out up to 100 new primary care teams every year, Dr Walsh said the HSE's claims that these teams were up and running were not reflected by the experiences of GPs on the ground.
However, the ICGP said it welcomed the various encouraging statements on the role of primary care by HSE chief executive Prof Brendan Drumm. "The broad strategy of the HSE to reorientate the health service towards primary and community services is very welcome," it said.
The Primary Care Strategy, which was originally published in 2001 when Micheál Martin was Minister for Health, promised a "one-stop shop" where patients could access an expanded range of health services in the community.
Central to the strategy was the creation of primary care teams, staffed by GPs, nurses, occupational therapists, physiotherapists and other healthcare professionals.
Following difficulties implementing the strategy at 10 pilot sites, it was announced in 2006 that some 100 new primary care teams would be rolled out annually.
But the ICGP warned in its statement that "resurrecting the concept of the enlarged primary care team and announcing plans to roll out up to 100 new teams per annum, may not be any more acceptable to GPs now than it was the first time".
And it said that "specialists" such as physiotherapists and social workers may be valued members of a primary care team but were not part of the general practice based team, staffed by "generalists".
The general practice team members are defined professionally not by a particular skill but by their patients - "not just any patients but by a named list of individuals and families, who together make up a local community", it said.