GP funding cuts are bad medicine

Highlighting the reduction of the influenza vaccine payments to €15 for GPs does not consider the big picture in general-practice payments (Irish Examiner July, 15).

GP funding cuts are bad medicine

It is hard to reconcile that figure with the €34 per pandemic vaccine the HSE funded itself in the 2009 public immunisation clinics.

When these cutbacks take effect, the annual income from the medical-card scheme to GPs will be down 5-10% from 2008, to €415m, or 3% of the public-health budget.

Over the same period, GMS patient numbers will increase from 1.44m to 2.1m. This medical-card population comprises the oldest, sickest and poorest in society and will consume 75% of general-practice resources.

These figures relate to gross income and include practice development and running costs.

To put these figures into context, according to a recent statement by the Royal College of General Practice UK, GPs “currently receive only 9% of NHS funding, despite family doctors carrying out 90% of the NHS contacts,” which is a similar figure to the Irish workload.

The RCGP is calling for general practice to “be given at least 10% of the ring-fenced NHS budget”.

Translating those figures into the Irish context, the Irish medical-card patient workload in general practice would be funded there with €900m.

Senior HSE administrators say that the “money-follows-the-patient” policy only applies outside of general practice, and will not apply in the official, national chronic-disease management plan, which will have to be paid out of the medical-card budget.

Many GPs were doing this anyway, but the latest cut-backs will mean that many of us will have to look at our work practices and adhere to our GMS contract more rigorously, or else charge GMS patients for services not covered by that contract.

Those of us who earn more should shoulder the greater burden of cuts in this economic crisis.

General practice is considered the most efficient part of the health service and the most effective form of health funding in reducing health-inequalities in the community.

Have the cuts to general practice, to sustain wastefulness elsewhere, gone too far and put the final nail in the coffin of universal healthcare?

Dr William Behan

Cromwellsfort Road

Walkinstown

Dublin 12

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