GPs urge deferral of free care for under-sixes

The introduction of free GP care for children under six should be put on hold in favour of widening medical card access to those most in need, a representative body has said.

The National Association of General Practitioners (NAGP) is urging all family doctors to refuse to sign any contract for the Government’s proposed scheme of giving all under-sixes free GP care. The introduction of GP visit cards to under-sixes was initially planned to begin last summer but was deferred.

The NAGP has around 1,200 members out of around 2,300 GPs, but has not been included in talks to decide a revised GPs contract and a contract to commence of the under-sixes scheme. With negotiations already taking place between the Department of Health, HSE, and representative body the Irish Medical Organisation (IMO), Health Minister Leo Varadkar is hopeful of getting this first element of universal health care in place during 2015.

However, the NAGP says doctors have an ethical and moral responsibility to prevent the introduction of a scheme that will increase abhorrent inequities in the health service.

NAGP chief executive Chris Goodey said GPs are not against universal healthcare but said those who need medical care most should be prioritised when resources are very scarce.

“Giving free GP cards to parents and children who perhaps don’t need them is not a priority,” Dr Goodey told RTÉ radio. “I just don’t see that the starting point should be on the basis of age, it should be on basis of need only, and it should be on the basis of children with chronic diseases and with cancer.

“If we’ve got money to spend on free GP care, let’s increase the threshold. We have 2m people with medical cards, let’s make it 2.1m people with medical cards and so on, until we get everybody on medical cards and that’s the ideal situation.”

The NAGP was consulted on the draft contract a year ago, along with the IMO and Irish College of General Practitioners, but it did not have a negotiating licence until last November.

The talks between the department and IMO on the contracts had already begun, and Mr Goodey said they have been seeking to have their voice heard. He expressed confidence that members will heed the NAGP call not to engage with the scheme, even if the IMO does negotiate and agree a contract for its operation.

An IMO spokeswoman said it has consistently told the Government that a patient’s age should not be a critical factor when prioritising the rollout of GP care to the whole population.

“The IMO is in negotiations with the Department of Health and the HSE on both an under-six contract which is Government policy, and a wider, new GP contract which should be capable of providing the means to deliver chronic care programmes, which are a key priority for the IMO,” said the spokeswoman.

She said it supports free care but it must be delivered in a planned way, with adequate resources, rather than loading complex workload into a GP system decimated by years of cuts and demand struggles.