Is free GP care for kids a good idea? : No

This Government has recently given political reform a bad name by its misdirected referendum campaign.

It looks now as if it’s about to do the same for health care reform by extending medical cards to every child under five regardless of family income at the same time as its rationing discretionary medical cards for many very deserving patients.

The Irish Examiner has done trojan work in recent days in highlighting the rationing of discretionary medical cards amongst very sick patients.

The paper has highlighted that the medical card system is not fit for purpose and it’s impossible to consider the supposed move to extending this system to everyone under the age of five without appreciating the plight of people dependent on discretionary cards.

While the Irish Medical Organisation supports universal access to GP care, we have always argued that it must be properly planned and adequately resourced. This move makes no sense and there appears to be little rationale behind it. The IMO is disappointed in what seems to be clearly a cheap political stunt at a time when there are insufficient resources to cope with the scheme as it exists. The medical card scheme is a key support for low-income families and provides a critical lifeline for hundreds of thousands of people who rely on the scheme to cover healthcare costs. Yet discretionary cards are being withdrawn every day.

Yes, the IMO support universal access to GP care but it must be adequately planned and adequately resourced. Expanding GP care in such an ad hoc fashion makes no sense.

The Government is promising GP care to the entire population by the end of its first term, yet there seems to be no cohesive plan to put this in place. In last year’s budget, free GP care was promised to those on the long-term illness scheme yet that failed to materialise.

Apparently, extending free GP care to this group was unduly complex from a legislative point of view but no explanation of what those legislative complexities are has been given.

In this budget, the goalposts have changed. GP care is now to be extended to the under-5s but there is no health evidence to back this move up. The general medical scheme is designed to protect the poorest and most vulnerable in society and the IMO believe the whole integrity of the scheme is lost by this move.

Income criteria remains the most effective way to capture needy groups and we believe this is a case of robbing Peter to pay Paul — there are undeniable cutbacks to the discretionary card scheme, and while the Government and HSE says there is no change in the criteria, it still remains a fact that the numbers are being reduced quite drastically. Any expansion of patients to be covered by the medical card scheme must not come at the expense of reduced cover for low income groups.

The IMO, of course, is in favour and supports universal access to GP care, however the resources are simply not there to deal with the current needs. We have grave concerns as to the priorities of Government policy at a time when the health budget has been continuously slashed and demand has increased. The resources are not there to deal with the current needs yet alone bring in a new patient population.

It is amazing that the Government should again announce extension of free GP care without any discussion with the GPs expected to deliver the service.

* Dr Ray Walley is chairman of the IMO GP committee.