IMO and Competition Authority settlement could affect GP child care

Any agreed settlement between the Irish Medical Organisation (IMO) and the Competition Authority could have signficant implications for the impasse between GPs and Government over its plans for free medical cover for children under six.

The position of the Government (and its predecessor) in recent years has been that under competition law it cannot negotiate directly with the IMO on fees.

Governments have argued that GPs, unlike hospital consultants, are not employees of the State but are independent contractors.

The legal action stems from the contention of the Competition Authority that threats by the IMO to withdraw from services not covered specificially in their contracts, following a Government decision last year to cut payments unilaterally, represented an attempt, directly or indirectly, to fix fees paid by the State.

The IMO has counter- claimed that it is entitled to negotiate on behalf its GP members. Presumably any agreed settlement would have to involve some mechanism which would give the IMO some rights to represent its GP members in talks on fees.

In the stand-off with the IMO over its plans to introduce free GP care for children under six, the Department of Health has insisted that, while consultations could be undertaken on fees, the Minister must set the fees.

This stance has antagonised GPs who fear that the proposed contract on services for young children would become a model for the introduction of similar schemes to cover the entire population.

GPs say they do not have the resources to take on extra under-sixes and have expressed outrage that the Governent planned to give healthy children medical cards while taking them from others who are seriously ill.

They are also angry at proposals, for doctors who do not sign up to the new deal, to lose their existing under-six medical card patients, which GPs warn could cause chaos.

Minister of State at the Department of Health Alex White said many aspects of the proposed deal could be addressed in talks with the IMO and has indicated that there may be room for some flexibility on fees.

For the last fortnight or so the IMO and Department of Health have discussed ways of having a more formal engagement on the scheme. Any settlement in the dispute with the Competition Authority could provide a more formal mechanism for discussions.