The Programme for Government provides for significant strengthening of primary care services to achieve Universal Primary Care (UPC) with the removal of cost as a barrier to access for patients. In order to deliver on this commitment, the preparation of a new General Medical Services (GMS) contract with GPs will be required. The Department and the HSE are currently examining the changes that need to be made to the GMS contract to facilitate the introduction of Universal Primary Care.
In 2007, the Department received legal advice that both European Union and national Competition law preclude the fees payable to self employed health professionals being settled on a negotiated basis.
In August 2011, following contacts initiated by the Minister for Health, the Competition Authority advised on what the Irish Medical Organisation (IMO) can and cannot do under Competition law. The IMO can, for instance, negotiate non-fee related elements of the contract. It can also present the views of GPs in the course of consultations on the contract, including matters relating to fees. Competition law does, however, preclude the IMO from organising collective action by GPs, including collective withdrawal or boycotts, in order to force the State into paying more than it is willing to pay for GP services. The key issue is that the Minister makes the final decision on what the State will pay under the contract.
I have recently had discussions with the IMO during which I outlined the Government’s policy in relation to free GP care. I intend to engage in further discussions with the IMO once the legislation regarding the extension of free GP care is published.