CHANGES IN eligibility criteria for medical cards for the over-70s will have a severe impact on the range of services offered by family doctors, it has been claimed.
Urban practices, especially those in affluent areas of Dublin, Wicklow, Meath and Kildare as well as Cork and Galway, face a drop in gross income of between €80,000 and €130,000 following the Budget decision to withdraw universal access to the medical card scheme for older people. Other practices will be hit to a lesser extent.
The Irish Timeshas learned that some practices this week began the process of making staff redundant in the face of the sharp drop in fees brought about by the Government's decision.
A number of practices confirmed yesterday they were planning to let go doctors, practice nurses, receptionists and other staff because of the sudden fall in fee income from the State.
As a result, doctors say they will be forced to cut services such as diabetes clinics, warfarin clinics and vaccination clinics. Medical sources said there would be an immediate impact on health promotion and prevention initiatives.
There is also growing concern that general practices will be unable to continue to provide care for patients who are admitted to nursing homes as a result of the changes.
A medical practitioner who provides a primary care service to a nursing home said: "My expectation is that if the Government removes nursing home payments for older patients, nursing homes will be unable to get GPs to provide a service."
Practices that gained most from the introduction of the over-70s medical card are the hardest hit because the capitation fee for older patients was set at a level three times greater than the fee received for looking after "ordinary" medical card patients.