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Young doctors shut out of medical card system

ON July 9, the Competition Authority published a report into general practice and the medical card system. In doing so, it revealed an apparent culture of hierarchy and entitlement that has existed for decades in Irish medicine.

In effect, young, fully trained GPs have been prevented consistently from treating medical card patients who wished to attend them. In many cases, only those doctors who had gained the approval of their local senior established colleagues were allowed access to the public primary care system.

As the report reveals, this discriminatory approach was effectively endorsed and supported by the Irish Medical Organisation (IMO). The result was that young doctors were discouraged from setting up practices in areas where their services were needed and patients were often denied a choice of practitioner.

In my opinion, those in authority have consistently put the financial interests of senior GPs ahead of the careers of their younger colleagues. The resultant loss of patient choice was apparently considered acceptable “collateral damage”.

The Competition Authority has forensically exposed this effective discrimination and has made a series of recommendations, most notably that all fully trained GPs should be entitled automatically to treat medical card patients and be paid accordingly. Without any apparent sense of irony, the IMO has “broadly welcomed” this report. It is to be hoped it will now reverse its policies and support the recommendations in full.

I congratulate the Competition Authority and the Minister for Health for this timely and well-written publication. It is to be hoped that its findings will be implemented as quickly as possible, with or without the support of the IMO.

Dr Ruairi Hanley MICGP

Beaufort Place


Co Meath


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