GPs could be forced to work in primary care teams

THE GOVERNMENT is seeking to introduce changes to the contract with GPs which would make it mandatory for those in the general medical services scheme to work as part of primary care teams, the Minister for Health James Reilly has signalled.

Dr Reilly told the Dáil that the Programme for Government provided for the introduction of a new general medical services (GMS) contract with GPs which would have an increased emphasis on the management of chronic conditions such as diabetes and cardiovascular conditions.

“It is envisaged that the new contract, when finalised, will focus on prevention and will include a requirement for GPs to provide care as part of integrated multidisciplinary primary care teams.”

The Government is also working towards the introduction of free GP care on a phased basis as it moves towards a new system of universal health insurance.

Dr Reilly said the universal primary care project team, which involved officials from the Department of Health and the HSE, was examining “the changes that need to be made to the GMS contract to facilitate the introduction of universal primary care”.

The Government wants to introduce free GP care for about 50,000 people covered by the long-term illness scheme this year as part of its move towards universal primary care.

However, GPs have argued that more resources will be needed.

The Government is also facing difficulties in negotiating with doctors’ representatives in relation to fees as a result of restrictions under competition law.

The indication that GPs would contractually have to work as part of primary care teams under Government proposals, comes just months after it emerged that some doctors around the State were refusing to participate in the introduction of the Government’s primary care strategy in protest at cuts in their fees.

HSE’s national director for integrated care, Laverne McGuinness, told the Dáil Public Accounts Committee at the end of January that it was not compulsory under their contracts for GPs to take part in primary care teams.

She said 32 primary care teams did not have any GP involvement.

A background report provided by the HSE to the committee said that there was “a distinct lack of GP participation in particular areas of the country”.

“Work is ongoing to show GPs the benefits of primary care teams, but there are still approximately 180 GPs that are refusing to join primary care teams, with many others reluctant to engage for many reasons, mostly unrelated to primary care teams developments but rather [due to] industrial relations and local historical issues,” the report said.