Anger among doctors over a freeze on extending medical card entitlement was last night threatening to derail work on introducing new community health services.
The Irish Medical Organisation said a freeze was "unacceptable" and Dr Kevin Kelly, a member of its GP committee, said every doctor in the country should refuse to co-operate with the plan until the decision was reversed.
The freeze - revealed by the Minister for Health and Children during a press conference yesterday - was also condemned by the Society of St Vincent de Paul.
Ms Audry Deane, the society's social policy officer, said she was "shocked and incredulous" at what she saw as an "obscene" decision, which failed to take account of the needs of the most vulnerable members of society.
"A married couple with two children earning a little over £9,000 a year, does not qualify for a medical card," said Mr John Monaghan, chairman of the national social policy committee. "That in this day and age is just not acceptable," he added. The society is expected to return to the attack at the launches of its annual report today.
At the press conference, Mr Martin said he planned to extend medical card eligibility to 200,000 extra people, beginning in 2003. The time-frame would depend on "budgetary considerations", he said. He envisaged a far more generous means test for people with children, he said.
Fine Gael's health spokesman, Mr Gay Mitchell, said his party would double income eligibility limits for cards, in its first year in office, while Labour's spokeswoman, Ms Liz McManus, said GP care should be free for everyone.
Both parties said the decision would ensure continued hardship for the poor.
Yesterday's launch of the primary care strategy was one of a series of national health strategy presentations which began on Monday and will stretch into next week.
The strategy envisages that in ten years the country will have a network of 600 "primary care teams", which will replace the GP service as it stands today.
Teams of GPs will work from buildings which will also house nurses/midwives, physiotherapists, occupational therapists, speech and language therapists, social workers and other health professionals. Patients will be "encouraged" to register with a particular team, though they will be free to go elsewhere if they wish.
Nurses will make up the single biggest group in each team and the move was described by the Association of Irish Nurse Managers as representing "a seismic shift in the focus of initial health care from the secondary or hospital care to primary or community care."
The Irish Medical Organisation, the Irish College of General Practitioners and the Irish Nurses' Organisation also welcomed the new strategy.
The full text of document, Primary Care - A New Direction is available at The Irish Times website, ireland.com