Labour proposal for free GP care ran into difficulty from the start


BACKGROUND:Róisín Shortall’s departure spells further trouble for the Government’s ambitious plans to introduce free universal primary care, writes PAUL CULLEN, Health Correspondent

FREE GP care for all was the promised land pledged by the Government to a weary people when it assumed office in March last year.

It was not going to happen immediately, but the programme for government set out a series of steps along the way, starting with legislation and the extension of medical cards to people with long-term illnesses.

To ensure it got the priority it deserves, a minister of state with responsibility for primary care was appointed within the Department of Health.

Róisín Shortall’s job was to oversee the development of a network of primary care centres around the country, boosted by extra staff from funds specially ring-fenced for the purpose.

The plan ran into difficulty from the get-go. It was, after all, a Labour Party proposal that fell to be implemented by a Fine Gael Minister. Shortall repeatedly sought delegated powers from Dr James Reilly but was refused them.

The last budget saw €20 million supposedly ring- fenced for the development of primary care centres and €15 million set aside to cover the cost of the first phase of primary care, extending the scheme to people with long-term illnesses.

Shortall and her officials set about deciding which areas should be prioritised for primary care centres based on criteria such as deprivation and the availability of local accommodation.

The programme for government promised this first phase would be introduced by last March. It was then promised that the necessary legislation would be in place by the summer recess. Neither deadline was met and the legislation still has not been published, yet Reilly still rejected an Irish Times story this month that claimed the initiative was running a year late.

Yet this is the case, as subsequent events have shown. The money allegedly allocated has not been spent and for the most part will not be spent this year. It is what the troika, which is attempting to call the shots on the runaway health budget, calls “time-related savings”.

In addition, Reilly prioritised his legislation to reform the HSE over the primary care legislation. Speaking to the Dáil last week, Shortall admitted as much when she bemoaned the lack of priority given to the free GP legislation and called for the allocated funding to be restored.

Minister for Transport Leo Varadkar went even further last Sunday when he said the primary care money was not available for next year, let alone this year.

The fact is that the department has not even talked to the Irish Medical Organisation, whose GP members would be profoundly affected by these proposed changes. It argues that competition law has to be changed before it can even sit down to talk about changes to the GP contract.

In this context, the row over Reilly’s decision to add 15 locations, including two in his constituency, to the primary care centre list prepared by Shortall is merely the latest chapter in an increasingly messy saga.

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