Minister of State at the Department of Health Alex White’s more conciliatory approach to family doctors at the annual meeting of the Irish Medical Organisation (IMO) on Saturday is a welcome sign of realpolitik on behalf of the Government. Having initially been faced with a “take it or leave it” attitude on the publication of an impractical draft contract for free GP care for all children under six, doctors may now respond positively to the Minister’s invitation to the IMO to enter into “talks about talks.”
The first plank in government policy aimed at the introduction of universal health insurance (UHI) in 2019, free GP care for all under six is not without controversy. At a time when people with documented medical needs are having medical cards removed by the Health Service Executive, it is reasonable to question why additional funding has been found to offer free care to healthy children under six, regardless of their parents’ income. Whether the new system will mean doctor visit cards for all children, or if those children currently in possession of a full medical card will retain the right to free medication, remains unclear. In the latter event, the Minister may, however unwittingly, introduce an element of inequity that is surely at odds with a UHI policy of equal and universal healthcare for all.
General practices around the country are already struggling to provide a safe and quality service to patients following a series of funding cuts under Financial Emergency Measures in the Public Interest (FEMPI) legislation. These cuts have been applied to practice support grants which fund equipment and the employment of practice nurses. It is a well-documented phenomenon that when patients become eligible for free GP care, patient visiting rates increase. Any sudden expansion in eligibility in an already stretched service carries with it a risk to patient safety and therefore the system must be stress -tested in advance of this.
But first both sides must enter talks without delay, united by a common goal of free GP care for all citizens.