I am happy that we have been able to conclude an agreement with the IMO on a major package of GP contractual reforms which will benefit patients and general practitioners, and make general practice a more attractive career option for doctors.
Agreement has been reached on the provision of new services, including a structured chronic disease programme, commencing in 2020, which will benefit over 430,000 medical card and GP visit card patients. A wide-ranging set of modernisation measures has also been agreed in the areas of eHealth, medicines management and multidisciplinary working.
There will be increased support for GPs working in rural practices and for those in disadvantaged urban areas. Improvements in the maternity and paternity leave arrangements have also been agreed, in recognition of the need to ensure that general practice is compatible with doctors’ family friendly commitments.
Under the terms of the current GMS contract, GPs are required to provide eligible patients with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess." There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for medical services provided under the contract.
GPs contracted by the HSE under the GMS scheme are obliged to provide services to their medical card and GP visit card patients, including those resident in nursing homes. GPs are remunerated for these services primarily on a capitation basis, with a range of additional support payments and fees for specific items of service. Currently, an annual capitation payment of €434.15 is payable in respect of each GMS patient over 70 years of age residing in a private nursing home approved by the HSE for periods in excess of 5 weeks.
The recent phase of talks with GP representatives did not specifically address the provision of services to residents of nursing homes but focused on the development of a range of modernisation, reform and sustainability measures for GMS and GP visit card patients. Along with most other capitation rates, the nursing home rate will increase by approximately 48% over the next 4 years, under the recent agreement.