GP in test case to stall free care for under-6s

A medical doctor has launched a High Court action against the HSE arising out of its plans to provide free GP services to children under six years of age.

In what is regarded as an important test action, Clare-based doctor Yvonne Williams wants the introduction of the new scheme postponed until her representative body, the National Associa-tion of General Practitioners (NAGP), has an opportunity to negotiate the scheme on behalf of its members.

It is claimed the proposed scheme, which is due to come into effect in July, to provide free healthcare to all children under the age of six, will result in changes to Dr Williams’s General Medical Services (GMS) contract with the HSE.

The GMS contract is the agreement between GPs and the HSE for the delivery of primary care services to medical-card holders. She claims the changes to her GMS contract are being imposed on her unilaterally.

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She also says the exclusion of the NAGP from the negotiation of the new contract has “gravely prejudiced” her. Her action is being supported by the NAGP, which claims the HSE has acted in breach of contract.

In a sworn statement grounding her application, Dr Williams said the scheme will lead to a “dramatic increase” in the frequency with which the under-6s will present at her practice.

She said it would “not be possible to accommodate the increased demand” and to try to do so would “compromise the care of all her patients”. It would be “profoundly unethical” for her to enter into the new contract with the HSE.

She also fears if she were to refuse to sign she would put the future of her practice in jeopardy. If she did not sign, the parents of her under-6 patients that have medical cards would move to “whatever practice the HSE assigned their children to”.

Private patients under the age of six would also leave her practice “to avail of free treatment elsewhere”.

Dr Williams said she was being placed in “an impossible position” of either signing a new contract that she believes will compromise her patients’ care or face having to close her practice.

She asked the HSE to postpone the introduction of the scheme, but they have failed to do so.

As a result, she has launched High Court proceedings seeking injunctions, including one restraining the HSE from removing any patients under the age of six from her GMS list until the proceedings are determined. She is also seeking orders restraining the defendant from reducing payments due to her under her GMS contract.

Yesterday Mr Justice Anthony Hunt granted Dr Williams permission to serve short notice of the proceedings against the HSE. The application was made on an ex parte basis, where only one side was represented in court.

The judge made the matter returnable to Wednesday of next week.

In a sworn statement to the court supporting Dr Williams’ action, NAGP chairman Andrew Jordan said the organisation, which has 1,281 members, has been “wilfully excluded” from talks concerning the under-6s scheme and changes to the GMS scheme.

He said the HSE and the health minister had engaged with the Irish Medical Organisation about the proposed new scheme.

This was to the exclusion of “a significant general mass of the GPs”, and this “selective” action has had “a profound impact on the rights of members of the NAGP”, he said.

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