GP contract discussions (not negotiations) are surely high on Minister Reilly’s to-do list.
Restructuring the entire health service aside, the need for a new GP contract has become even more pertinent, as confusion reigns on which services are part of the GMS contract and which lie outside the 20 year-old document’s remit.
The promise given in the Programme for Government to amend Irish competition law and thus open up the GMS scheme will soon be addressed by the passing of the Health (Provision of Services) Bill 2011 but one would wonder where this languishes on the same to-do list.
All restrictions on qualified GPs holding a GMS contract and treating medical card patients will be removed, and Minister Reilly has vowed that the paucity of primary care in “unattractive” areas will be addressed by incentives for newly certified members in order to ensure the consistent and balanced provision of care.
Indeed, in a recent debate in the Seanad on the Bill, the Minister stated, in line with recommendations from the Competition Authority, that the Department of Health will be “allowing and encouraging open competition”, a seachange in attitude that may change the whole face of general practice.
The debate on the inconsistency of GP fees has raged on the airwaves and in the press, and now certain doctors are offering cut-price consultations and services and openly advertising these reduced prices.
The beginning of a “price war” has been denied in the IMO’s favourite town of Killarney, where two GPs recently established a practice offering not only reduced fees, but also longer and later surgery hours.
At this practice, a “basic consultation” will cost €40, significantly less than the €50-60 charged by other doctors in the town. The surgery is also offering consultations for just €25 for secondary school students.
Previously not permitted to advertise, the Competition Authority persuaded the Medical Council to lift such restrictions on GPs at the end of 2009.
This has not, however, led to a glut of advertisements in the local and national press by practices trying to bring their range of services to a bigger audience. Until now, that is, as those offering lower prices are understandably keen to make this known.
The idea that it is not the “done thing” is evident from the shocked reaction to the recent advertisement by the low-cost Killarney doctors in the local Kerry press.
Speculation among locals that this would commence the aforementioned price war in the tourist town even garnered national coverage when it was reported in The Irish Times.
Patients have a relationship of trust and respect with their GP, and aren’t necessarily going to automatically switch to a different doctor, purely on the basis of price. Yet, this is a recession, and everyone is looking to reduce their outgoings.
Although Minister Reilly’s ultimate mission is to give the entire population free GP care, the vast discrepancies in GP fees need to be addressed, as does the uneven distribution of practices throughout the country.
If universal healthcare is to be in place by 2016, there is a lot of work to be done in reforming the delivery of primary care over the next four years. The new Bill will see the beginning of that.
