€440m in GP payments under state schemes

PAYMENTS to GPs under the medical card scheme and other state subsidies more than trebled in the past decade, reaching a record €440 million last year.

The top-earning practice under the schemes was run by Dr Anthony Crosby, Howth Road, Raheny, Dublin, which received more than €700,000 in fees and nearly €80,000 in practice supports, making a total of €781,111.

A further 30 doctors received sums in excess of €500,000 and a total of 736 earned €250,000 or more, including Fine Gael spokesman on health, Dr James Reilly TD, whose practice in Lusk, Co Dublin was paid €305,207.

Fellow TD, Dr Jim McDaid of Fianna Fáil, received €167,701 for his practice in Letterkenny, Co Donegal, while Dr Jerry Cowley, the former independent TD who lost his seat last year, got €408,964 for his practice in Mulranny, Co Mayo.

A total of 2,126 family doctors were eligible for payments under the

Primary Care Reimbursement Service last year — mainly for caring for non-paying medical card patients but also for operating the free GP visit card scheme, childhood immunisation programmes and the methadone treatment scheme.

GPs can also claim “practice support” to assist with the costs of hiring nursing and secretarial staff. At the lowest end of the scale, 46 doctors earned less than 1,000 from the combined schemes last year.

The costs of the various schemes have risen sharply in recent years — from €130m in 1997 to €440m in 2007 — but Dr James Reilly, who appears in the payments list as Dr James MacDonnell-Reilly, said the public was getting value in return.

“Primary care is one part of the healthcare system where all the analysis shows we do get value for money. When you take it that you get a set fee of €40 per child no matter how many times that child attends your surgery in a year, I don’t think anyone could argue that’s excessive.”

Fees per medical card patient vary with the age of the patient and doctors are paid larger sums, running into several hundred euro, for elderly patients in long-term nursing homes, so doctors with more older and welfare dependant patients tend to be at the higher end of the payments scale. All GPs receiving state payments can care for private patients.

Dr Reilly said he had no problem with the payments being made public but he stressed that they were payments to practices rather than individuals. “In the case of my surgery, apart from myself, we have two full-time GPs, two half-time GPs, one practice manager, the equivalent of one-and-a-half whole-time nurses and three secretarial and reception staff so the fees paid cover a lot of work by a lot of people.”