GPs may be forced to cut their services, IMO warns

THE IRISH Medical Organisation (IMO) has warned that GPs have had to reduce the level of services provided as a result of fee reductions introduced by the Government last year and that further restrictions could be on the cards if more cuts are imposed.

It has signalled that waiting lists for GP services could emerge and that family doctors might have to stop providing services currently made available on a pro-bono basis for medical card patients.

In a submission to the Department of Health, the IMO said that since January 2009, doctors’ income from the general medical services scheme (GMS) had been cut by more than €76 million as a result of an 8 per cent reduction in professional fees and allowances, and the introduction of a single capitation rate for treating patients over the age of 70.

The IMO said that while loss of resources under the GMS had been offset to some extent by increased numbers of patients qualifying for cover under the scheme – mainly due to rising unemployment – there had also been “a catastrophic fall” in earning from the private sector as a result of the economic downturn. It said that many of the additional holders of medical cards had previously been paying themselves for GP care.

The IMO submission was presented to the Department of Health earlier this month as part of the review of the legislation governing the cuts in professional fees, which is currently under way.

The IMO said the cuts introduced by the Government’s emergency legislation last year had “penalised patients and reduced the range of services available from GPs”.

“They undermined the GP business model and led to reduced services for patients and the displacement of services from GP surgeries to other, often more expensive, areas of the health service,” the IMO submission stated.

The IMO said “a tipping point” was being approached after which the damage being inflicted on GP services “will escalate dramatically and the cost of repairing this damage in years to come will grow exponentially”.

It said it was time the Government addressed the underfunding of GP services within the broader health budget and that reversing the 8 per cent cut in fees paid to GPs should be the starting point of this new approach.

The IMO said that in a survey of 25 per cent of GPs participating in State-funded schemes, 97 per cent said they would not be in a position to take on any additional work and that services to patients would have to be reduced. It said that 97 per cent of GPs said they would have no option but to refer patients to hospitals or community services at an earlier stage.

The IMO also warned that it would be inevitable “that waiting times will become a feature of general practice and the much valued same-day service will cease to be”.

The doctors’ trade union also said that 92 per cent of GPs indicated they would not be able to offer the current range of services provided on a pro-bono basis to medical card patients.

These include patient phlebotomy services, warfarin monitoring, 24-hour ambulatory blood pressure monitoring, minor surgery and dressings.