Doctors have begun work on a Statewide influenza vaccination campaign, despite failure to reach agreement with the health boards on payment for the scheme.
Medical card-holders will be given the service free of charge, as in past years, and the Irish Medical Organisation is urging the elderly and others at risk to contact their GPs for vaccination within the next three to four weeks at the latest.
But, in the absence of a formal agreement for the payment of doctors, the organisation has told members to claim through the existing general medical scheme for out-of-hours work caused by the campaign.
The IMO said this "unsatisfactory, back-door method" of reimbursement had been forced on it by the continued failure to agree a proper footing for the flu vaccine scheme between doctors and the health boards.
It blames "obfuscation" by the Department of Health over a written agreement which it claims specifically excludes flu vaccination from the existing medical card scheme.
At a meeting yesterday, the Health Service Employers' Agency offered to refer the matter to arbitration, but IMO spokesman Dr Cormac Macnamara said the relevant clause was "so self-explanatory as to make the offer of arbitration a nonsense".
An estimated 180,000 medical card-holders are in the over-65 or other groups at potentially serious risk from flu, but fewer than 60 per cent of these are likely to present themselves for vaccination. A total of 250,000 people were vaccinated last year in a pilot campaign co-ordinated by the Office for Health Gain.
The IMO says doctors participated in last year's scheme on the understanding that negotiations on payment would take place well in advance of this year's flu "season". But the organisation insisted yesterday that the lack of negotiation was a temporary "blip" in an otherwise excellent working relationship with the Department and health boards.
While the risk presented by the virus this year is impossible to quantify, experts fear that increased air travel around the millennium, and the fact that there has not been an epidemic for several years, increase the chances of a major outbreak.
"The nightmare scenario for us as a medical profession is that we should be dilatory in any way," said Dr Macnamara, a member of the organisation's GP committee.
