Doctors urged to ‘start charging for everything’ to win new deal

Minister says Government wants to spend ‘many millions more’ on general practice

Delegates at the Irish Medical Organisation’s annaul meeting in Killarney, Co Kerry. Photograph: Shane O’Neill.

Delegates at the Irish Medical Organisation’s annaul meeting in Killarney, Co Kerry. Photograph: Shane O’Neill.


Doctors should make the public unhappy by “charging for everything” in order to get the Government to engage with them on a new GP contract, Irish Medical Organisation (IMO) members have been told.

The doctors’ group is holding its annual meeting in Killarney, Co Kerry and delegates have been told that general practice has become financially unviable and that the Government must urgently reverse austerity-era financial cuts.

Former IMO president Dr Ken Egan said he honestly did not see a new contract for GPs being put in place in the next five years. “The only way you will get anything is to make the public unhappy,” the Mayo GP said.

Dr Egan suggested that doctors should increasingly charge patients for services. He said the impetus for the government to introduce the original contract with GPs in the early 1970s was because dispensary doctors had started charging everyone a fee of £1, which drove the Department of Health to bring in changes .

“We are here today and saying general practice is falling asunder. But the patients are not saying that. I do not see patients out complaining,” he said.

“So in the real world it needs a lot more than us saying it. So it beholds you as a union to definitely to get into negotiations. But we are doing things cheaply . We need to start charging for everything.”

IMO chief operations officer Susan Clyne said it was up to each individual to decide on charges.

The doctors present backed a motion stating that a roadmap for unwinding cuts imposed under financial emergency legislation was needed before any new services could be introduced.

‘Many more millions’

Arriving at the conference, Minister for Health Simon Harris said the Government wants to spend many, many millions more on general practice in the coming years.

Mr Harris said “holistic” talks with GPs would commence within a month and be completed within a few months.

He said he had powers under new legislation to set fees for current services which he wanted to see at a sustainable and appropriate level.

Separately, he said the forthcoming talks would also look at what new services could be provided and if these were agreed, the Government would have to resource them.

“We are talking about wanting to spend many, many millions of euro more on general practice over the coming years,” he said.

‘For nothing’

Doctors are angry at the Government’s stance that it will not reverse the €120 million in austerity era cuts “for nothing “ and will want them in return to take on additional services.

The conference was told that general practice was facing a workforce crisis in the years ahead .

Dr Michael Kelleher said there were 2,536 GPs with contracts to operate the medical card scheme. However, he said 700 of these were in their 60s and would be retiring in the next few years.

Even more concerning, he said, was the collapse in the number of young doctors entering the scheme with fewer than 90 of the doctors working in it under the age of 35. He said only 380 were under 40, which he said was a frightening figure.

Dr Darragh O’Neill said the current picture of the retirements was worrying but what was likely to come afterwards was frightening.

Dr Liam Holmes said GPs in their 50s were closing their practices and moving abroad.

Dr Tadhg Crowley said when the impending manpower crisis in general practice hit, there would be “an explosion and we will go over the cliff”.

Dr John O’Brien said general practice was at a tipping point.

“Speaking about Fempi cuts and talking about putting extra work into general practice as a pay off for that is delusional. If we are to make general practice survive, we need an injection of new money now with no work attached to it.”

He said GPs around the country had no further capacity at all for any other work and were having great difficulty meeting the work that they were undertaking at the moment. He said 70 per cent of practices were now closed to new patients. He said this was an “absolutely outrageous figure” .