Scheme denounced as ‘medical apartheid’ welcomed by Sligo TD

McLoughlin tells Dail new ‘under 6 over 70’ medical service ‘will make real difference to lives of youngest and oldest’

Sligo News File Online

The government proposed scheme of free GP care for under-6s, slammed as “medical apartheid”, and which general practitioners have been urged to reject, has been welcomed by Fine Gael Sligo Leitrim TD, Tony McLoughlin.

Speaking during the Dail debate on the Health (General Practitioner Service Bill) 2014, McLoughlin said the commencement of the new GP under 6s and over 70s service, costing more than €67million, “will make a real difference to the lives of the youngest and oldest in our society, and for the families that care for them.”

He went on to say the service will mean real savings for pensioners and for families of young children,” and that “the two new initiatives in particular are part of the Government’s wider plan to enhance the Primary Care system in this country, whilst also achieving real savings in the health budget…”

However, the National Association of General Practitioners, which represents more than half of the country’s GPs, has recommended outright rejection of the plan.

In a statement following an emergency meeting of its National Council, the Association said “…all 23 members of the Council have voted to reject the under-6s contract based on the information currently available.

“The NAGP adamantly believes that the under-6s deal does not serve the best interests of general practice or patients. The Association has described the initiative as medical apartheid.

The statement quotes Dr. Andy Jordan, Chairman of the NAGP as saying that “this deal amounts to nothing more than medical apartheid. It is motivated by election votes rather than real patient need. The mortality rate in children less than 18 years of age is 3.8/10,000 and the vast majority of those are caused by accidents not illness. At the same time we have 5,000 deaths per year in Ireland from cardiovascular disease but there is no money to provide free GP care to those patients.

“The proposal will fuel the inequalities that already exist in our health service. The asthma scheme will only be available to children between 2 and 4; the diabetes scheme will only be available to people who already qualify for a medical card or doctor only card; the under-6s scheme will not cover medicines, x-rays, blood tests, A&E visits etc. It is simply a smoke and mirrors political stroke. The IMO, ICGP and NAGP are all of the same opinion – that the provision of free care must be prioritised for those who are in genuine need, be that medical or financial.

“The NAGP is calling on all GPs to stand firm and collectively oppose the contract.

Dr. Jordan is also quoted as saying that “there has been a lot of bullying and scaremongering in the last few days. GPs are being told that they cannot afford not to sign this contract, that if they don’t sign it someone else will.

The truth is that GPs cannot afford to sign this contract. The funding on offer will barely cover the cost of providing the service, which equates to an extra 4.5 million consultations per year. It certainly does not represent the financial lifeline it is being portrayed as.

“There is, without doubt, a desperate need for investment in general practice but investment needs to be allocated to the areas where it is needed – rural practice, general practice in deprived urban areas, comprehensive chronic disease management, existing services which are grossly underfunded.

“For the last five years GPs have had to sit back and accept more and more demand for less and less funding. That stops now. If we do not, as a group, stand together and oppose this scheme, we will be letting ourselves down and letting our patients down. It will allow the irresponsible erosion of general practice to continue.”

The NAGP said it has repeatedly warned that general practice is at breaking point. There is simply no capacity to take on an extra 4.5 million consultations per year at this point. An equivalent of €220 million in funding has been removed from the sector in the last four years through successive and disproportionate FEMPI cuts. This has resulted in significant reductions in staff and other resources. These issues must be addressed through the negotiation of a new GMS contract before GPs can take on any additional workload.

“In a recent survey, 92% of GPs supported the NAGP’s call for a collective refusal to sign the contract. It is now time for GPs to have the courage of their convictions. We must not be motivated by short-sightedness or self-interest. We must act in the best interest of all GPs and all patients.”

The National Association of General Practitioners is a licenced trade union representing more than 1,200.

The Irish Medical Organisation has said many speakers at the meeting convened to discuss the new contract acknowledged the achievement of the IMO in the negotiations and expressed support for the agreement.

However, they have also said that “others expressed their ongoing lack of trust in the HSE, concerns about the workload implications of the agreement and concerns about the damage caused to General Practice through years of under-resourcing.”

Their statement adds that “under the terms of the Competition Act, the IMO has won the right to negotiate on behalf of its GP members but is not allowed to recommend acceptance or rejection of any agreement. Members are required to decide individually whether to sign any new contract or not.”