Doctor’s action against free GP care for under-6s adjourned

GP says scheme would mean ‘dramatic’ rise in under-6s presenting at her practice

A medical doctor's High Court action against the HSE's plans to provide free GP services to children under six years of age has been adjourned.

In what is regarded as an important test action, Co Clare based Dr Yvonne Williams wants the introduction of the new scheme postponed until her representative body, the National Association of General Practitioners (NAGP), is given an opportunity to negotiate with the HSE on the new scheme.

In her action, Dr Williams claims the proposed scheme to provide free health care to the under-sixes, due to come into effect in July, will result in changes to her General Medical Services (GMS) contract with the HSE.

The GMS contract is the agreement between GPs and the HSE for the delivery of primary care services to medical card holders.


She claims the changes to her GMS contract are being imposed on her unilaterally, and the exclusion of the NAGP when new contract were being agreed had “gravely prejudiced” her.

Various injunctions

As a result, she launched proceedings seeking various injunctions including one restraining the HSE from removing any patients under six from her GMS list until the proceedings are determined.

She also seeks orders restraining the HSE from reducing payments due to her under her GMS contract. Her action is being supported by the NAGP.

On Friday, Mr Justice Anthony Hunt granted Dr Williams, a GP based in Shannon Co Clare, permission to serve short notice of the proceedings against the HSE.

On Wednesday, when the matter came before the court, Mr Justice Raymond Fulham agreed to adjourn the matter to allow the sides exchange legal documents.

The HSE, represented by Eileen Barrington SC, said it had confirmed in recent days that it will not reassign any existing under-six GMS patients during the summer period.

GPs who have not signed up for the new contract will be paid for such patients on current GMS rates and not under the new rates applicable for the under-sixes contract.

Clarifications issued

The HSE said while there had been uncertainty among GPs, it has issued certain clarifications.

It said the patient registration process for the under-sixes will start in early June, and it will publish a list of all GPs who have agreed to provide this service.

The matter is to be mentioned before the High Court on June 11th, when it is hoped a date for the hearing of the action can be fixed.

In a sworn statement, Dr Williams, represented by Eanna Mulloy SC and Phelim O'Neill solicitors, said the new scheme would lead to a "dramatic increase" in the frequency with which under-sixes would present at her practice.

She said it would not be possible to accommodate the increased demand and to try to do so would compromise the care of all her patients.

It would be “profoundly unethical” for her to enter into the new contract with the HSE.

She feared if she were to refuse to sign the new contract, which she believed had to be completed and returned to the HSE by either late May or early June, her practice would be put in jeopardy.

If she did not sign, parents of her under-six patients that have medical cards would move to whatever practice the HSE assigned their children to. Dr Williams said she was being placed in “an impossible position”.

She had asked the HSE to postpone the introduction of the new scheme but they failed to do so, she claimed.