DOCTORS' FEES:A SENIOR public servant has been appointed by the Government to recommend a new single rate of payment to family doctors treating all over-70s medical card holders.
Eddie Sullivan, chair of the Public Appointments Service, has been asked to take submissions from the Irish Medical Organisation (IMO), which represents GPs, and the Health Service Executive (HSE), as well as other interested parties before reaching his decision.
Submissions must be made by this Friday and Mr Sullivan has been asked to make a recommendation to the Government by this day week after considering these submissions.
GPs have been paid four times more for treating non means-tested over-70s medical card holders since an automatic entitlement to medical cards for all those over-70 was introduced by the Government in 2001.
At present, they get paid an annual fee of €640 for each person over-70 who automatically got a medical card without a means test, while they get paid €160 a year for looking after those who are over-70 who already had medical cards by virtue of a means test before they reached their 70th birthday.
The new flat fee for GPs for treating the over-70s will have to be set somewhere between the €640 and €160 currently paid. At present, 355,000 over-70s have medical cards and capitation fees to GPs in respect of them cost around €124 million a year.
If the single capitation rate for over-70s was set at €325 a year, the total cost would come down to around €108 million, generating savings of around €16 million, the amount which Minister for Health Mary Harney has said would be saved in capitation fees among this age group as a result of the changes. Meanwhile, a separate process has been established by the Government to look at ways of making savings on drugs prescribed by GPs under the medical card scheme, which could also bring down costs.
A group chaired by Dr Michael Barry, a consultant clinical pharmacologist at the National Centre for Pharmacoeconomics at St James's Hospital, Dublin, will make recommendations on how savings can be made in this area by December 1st. Dr Barry has published widely on the cost-effectiveness of medicines.
Taoiseach Brian Cowen said the IMO had made the suggestion in relation to looking at bringing down drug costs without compromising patient care, presumably in part by prescribing more generic drugs as was suggested by the Irish Pharmacy Union in its recent dispute with the HSE.
The Government has also announced that the Competition Act is to be changed as quickly as possible to allow the IMO to represent its members in negotiations with the HSE and the Department of Health in future. The IMO has been seeking to negotiate a new GMS contract with the HSE since 2005, but has been prevented from doing so by current competition legislation which states that for a union to negotiate fees on behalf of its members with an organisation like the HSE would be regarded as price-fixing and would be against the law.
The IMO, in a statement, said it was pleased the Government had found a way to ensure the overwhelming majority of people over 70 years of age would not lose their medical cards.
"We are also pleased to note the Government's commitment to pursue amendments to the Competition Act 2002 to enable the IMO to represent its GP members in negotiations with the Department of Health and Children and the HSE," it said.
"The IMO notes but does not share the concerns raised by the Competition Authority," it added.
It also confirmed it will make a submission to Mr Sullivan on the proposed new capitation rate for doctors in the GMS who are caring for patients aged 70 and over by Friday.
Meanwhile, a meeting of the IMO GP committee which was due to take place tonight has been cancelled. Its understood the IMO is worried that any such gathering where a discussion on the setting of the new capitation fee might be discussed could be seen as being in breach of current competition legislation.