GP union rejects under six deal at emergency meeting

The proposed new deal to provide free family doctor care to all children under six was rejected by the National Association of General Practitioners (NAGP) at an emergency meeting on Sunday.

All 23 council members voted against the deal and the association described the iniative as “medical apartheid”.

Dr Andy Jordan, chairman of the NAGP said provision of free care must be prioritised for those in genuine need, both medical and financial.

“ It is motivated by election votes rather than real patient need. The mortality rate in children less than 18 years of age is 3.8/10,000 and the vast majority of those are caused by accidents not illness. At the same time we have 5,000 deaths per year in Ireland from cardiovascular disease but there is no money to provide free GP care to those patients,” he said.

The union, which represents about 1200 GPs, has called on all GPs to stand together against the contract.

Irish Medical Organisation

Earlier, Irish Medical Organisation’s GP committee chairman said the under six deal represented first step on the road back to a sustainable and viable general practice system.

However Dr Ray Walley warned that there was no trust on the part of many doctors in the Department of Health and the HSE providing additional resources to general practice.

He said speaking at a national meeting of GPs held at the IMO’s annual conference in Kilkenny convened to discuss the agreement reached between union negotiators and the Government last Thursday which provided for the provision of free family doctor care for all children under age six.

The media was excluded from much of the meeeting but could report on a discussion between GPs and the Minister for Health Leo Varadkar.

In a statement issued after the meeting, the IMO said many speakers had expressed support for the proposed new deal. However it said others voiced their on-going lack of trust in the HSE and spoke of their concerns about the implications for workload of the agreement and the damage that had been caused to general practice by years of under funding.

The Minister told the meeting that cuts imposed on general practice under financial emergency legislation over recent years would be reversed.

“They are not going to be reversed and just go back to the way things were beforehand. What we plan to do for all groups is to negotiate the unwinding of FEMPI( financial emergency legislation ) over a number of years. We will be looking for things in return for that.”

“The kind of things that we are asking in return is the under six (care deal), the new (care) arrangements for (children ) with asthma and (people) with diabetes.”

He said he would envisage that in future talks there would be a schedule drawn up for full reversal of the FEMPI cuts but that the public, patients and taxpayers would have to be getting something back for it.”

The Minister said he favoured re-introducing some form of drug budgeting scheme which encouraged GPs to prescribe more efficiently.

However he said there were mixed views on this issue. He said the ESRI was opposed to medicine management programmes but that the HSE, Minister of State Kathleen Lynch and himself were in favour of bringing back such an arrangement.

He said there were flaws in a prevous scheme which was abolished a number of years ago and care would have to be taken on the design of any new arrangement.

“The way perhaps it could be done is to match it with the use of preferred medicines.”

The Minister said GPs were still “pretty appalling” at generic prescribing and there were still lots of people still not prescribing peferred medicines.

Mr Varadkar said the existing system of paying GPs additional money on top of current medical card fees for carrying out special type consultations needed to be updated with some elements remunerated properly.

“They really are ante-diluvian at this stage.”

“I would not do suturing for €7 or €8. I know how long it takes. It has to be a fee that covers the material cost and the time cost. There is effectively two consultations.”