Free GP Care: robbing the poor to pay the rich?

‘In fact it’s robbing the poor to pay the rich.’

A new Bill for free GP care for all children under the age of six years was set to be introduced in 2014 but following numerous setbacks it has yet to be implemented.

The HSE states that ‘the provision of free GP care to children under the age of six represents the first phase in the provision of free GP care for the entire population and is part of the Government Health Reform Programme, Future Health, to create a single tier health service, supported by Universal Health Insurance with universal primary care including GP care without fees at the point of services.’ It will mean that all children aged six and under, will get free GP care, regardless of their parents’ income.

In June of last year, then Junior Minister for Health Alex White revealed that the introduction of this free GP care for under- sixes would not be introduced that summer as promised and instead would be introduced during that autumn. This too was postponed.

At the Joint Oireachtas Committee on Health and Children he told: “The 2013 Report of the Expert Advisory Group on the Early Years Strategy recommended providing access to GP care without fees to all children in this age group. There are good reasons to provide universal access to GP care in view of the health needs of the under-sixes age cohort.”

He continued saying: “The early identification of health issues at a younger age can mitigate or reduce the impact of ill-health later in life. We should bear this in mind when the Growing Up in Ireland survey has reported that almost 1 in 4 children in Ireland are either over-weight or obese, which is likely to lead to significant health issues later in life.”

The Budget 2015 included a provision for free GP care for all children under the age of six years. It was to be introduced following negotiations with the Irish Medical Organisation (IMO). The HSE set aside €25m in this year’s budget for free GP care for children under the age of six.

However this provision has not been received well by many GP’s. The National Association of GPs (NAGP), which represents 1,200 of the country’s 2,300 GPs, called on its members and non-members not to comply with the Government’s new free GP care scheme and not to sign up to the contract. Dr. Jacqueline Glisson states why she will not be signing the free GP care to under six contract in its current format:

‘I find this contract morally and ethically wrong. I see medical cards being removed on a weekly basis from the elderly, terminally ill and those with lifelong medical conditions who can ill afford to pay for their medical care. Instead cards will be given to the children of parents who don’t need the financial help. There is no justice or logic in that. In fact it’s robbing the poor to pay the rich.’

NAGP Chief Executive Chris Goodey said it was morally reprehensible that free GP care would be extended to all children under six, regardless of their medical needs or family income, adding it would only increase the abhorrent inequities in the health service.

The NAGP held a protest outside Dáil Eireann in September last saying that the Government’s plans for free GP care to children under six and adults over 70 would result in a threefold rise in GP consultation rates.

It argued that this would “result in shorter consultation times and three to five fold increase into secondary care as GPs will not have the time available to properly investigate and manage patient problems”.

The IMO, which represents about 1,800 GPs, said it is continuing to take part in negotiations about the implementation of the scheme.

The Chairman of the IMO’s GP Committee Dr Ray Walley said that although it had always advocated for medical cards to be prioritised on the basis of income and medical need, it accepted that the under-six scheme was now Government policy.

The provision for free GP care to all children under the age of six years is the first phase of providing free GP care for the entire population. However Minister for Health Leo Varadkar stated in February of this year that this is set to be delayed by up to three years or more.

Along with all children under the age of six years, providing free GP care to all adults over 70 years of age is also part of phase one of free GP care to all. Mr. Varadkar has stated he is “absolutely confident we will have the over 70s by the summer” but added: “The under sixes requires a little bit more negotiation.”

The next phase will be to extend free GP care to all children under 18 and subsequently to adults.

The move was initially intended to be put in place by the end of the Fine Gael-Labour Government’s term of office in 2016 but has been beset by delays. Senior sources now acknowledge the full implementation of the plan is unlikely to be completed until the middle of a second term in office for Fine Gael and Labour.

The general election is due to be held in spring 2016, and sources say the full roll-out of GP care is now likely to happen by 2019 or later.

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