GP care contract demands attention

I am quite surprised by the lack of media interest in the controversial government draft contract for providing free medical services for children under six. It is a publication of national significance as it clearly highlights how it plans to introduce free general practice services to the whole population.

Currently, we have the most “pro-poor” general practice service in Europe which compensates somewhat for the “pro-rich” hospital service. However, that is changing. Over the last year, GPs have seen patients at the fringes of society, and not able to cope with HSE bureaucracy, being deprived of full medical cards on “probity” grounds. Also more of the patients with the highest medical needs in society are being refused discretionary medical cards.

Intuitively, a lot of the proposals in the document sound like a good idea, but unfortunately little of it stands up to critical analysis. It proposes a massive diversion of clinical and administrative resources from evidence-based patient care into unnecessary bureaucracy and clinical activity. Mandatory universal “wellness assessments” is in direct conflict with the best international evidence. It is well proven to waste valuable healthcare resources and contribute to health inequalities via the inverse healthcare law; those with higher healthcare needs are less likely to avail of universal wellness assessments.