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GP fees ‘act as a disincentive’

24 Jan 2014

By Gary Culliton.

There is a lot of evidence that proves that even relatively well-off people will not go to their doctor because fees ranging between €50 and €60 act as a disincentive, the Minister of State with responsibility for Primary Care Alex White has said.


”We must remove the commercial relationship between the citizen or patient and his or her doctor. It is a progressive move that we must achieve,” said the Minister.

Meanwhile, Dr Ray Walley, Chairman of the IMO GP Committee, strongly criticised the Minster for Health on the issue of free GP-visit cards for children under six years.

Dr Walley said that the Minister was being “arrogant” by implying that he can simply dictate the terms of a revolutionary change in GP services without even discussing the issue with the IMO as the representative body for GPs. Dr Walley said Dr James Reilly “was courting disaster” by pressing ahead with the extension of GP-visit cards to children in “an unplanned, uncoordinated way. GPs are under massive pressure as it is and we will need more resources to be able to cope with the increased demand on our services that will follow from a sweeping extension of  GP-visit cards.  Change like this needs careful planning and negotiation and we’re not getting it from this Minister”.

Despite the extension of cards to under-sixes, 93 per cent of all persons over the age of 70 years will continue to have access to their GPs without fees, despite recent measures, Minister White insisted. A somewhat lower figure, 85 per cent, have access to a full medical card. The Government is committed to achieving the goal of a universal GP service before the spring of 2016, he said.

“New additional funding of €37 million” has been ring-fenced by the Government to fund the under-sixes initiative so that it does not draw on resources for the medical card scheme, commented the Minister.

In the recent budget, changes to the over-70s eligibility criteria were announced to deliver €25 million in savings during 2014 from the expenditure on over-70s medical cards, which is in the region of €750 million annually.

Under this legislation, the income limit for an over-70s medical card is to be set at €500 per week, equivalent to an annual income of about €26,000 for a single person. For a couple, the income limit for the over-70s medical card is to be set at €900 per week, equivalent to gross annual income of almost €47,000.

Those affected by these revised thresholds will qualify for an over-70s GP-visit card. A single person aged over 70 with a gross income of up to €700 per week, or approximately €36,000 per year, will continue to qualify for free access to a GP. A couple over 70 years of age with a gross income of up to €1,400 per week, or approximately €72,000 per year, also qualify for a GP service without fees. In addition, under the drugs payment scheme, the DPS, the HSE will meet the prescription drug costs of older people without a medical card who face drugs costs higher than the DPS threshold of €144 per month. This means that a single person aged over 70 with a gross income in excess of €500 per week or a couple with an income in excess of €900 per week will have to pay no more than approximately €33 per week on prescription drugs.

It is estimated that approximately 35,000 people will have their medical card replaced with a GP-visit card under the new income rules. Out of every five people aged over 70, the four poorest will not be affected by the budget measures, said Minister White.


24 January 2014

Click here to view the full article which appeared in Irish Medical Times