GENERAL PRACTITIONERS providing State services are not covered by the Croke Park agreement, the Department of Health has stated.
The agreement guarantees the Government will not introduce further pay cuts or seek compulsory redundancies from those covered by it in return for co-operation with reforms of the public service.
The Irish Medical Organisation has consistently argued that cuts in fees for family doctors would be against the terms of the Croke Park agreement.
In a briefing document on proposed fee cuts sent to the Minister for Health James Reilly last month, senior officials said the Department of Health “does not accept the contention that GPs are public servants or that the Croke Park agreement imposes any bar on the Minister reducing fees payable to GPs”.
General practitioners providing services for medical card holders or carrying out other services on behalf of the State such as immunisation programmes are not employees of the HSE.
Rather they are independent contractors who are paid by the HSE under a contract to provide such services.
There have been four rounds of cuts to GP payments under the various schemes since the Government introduced financial emergency legislation in 2009.
However, in their note to the Minister, Department of Health officials said that despite the reductions in fees in 2009 and 2010, the overall amount paid out in fees and allowances to GPs by the HSE had actually increased.
The Department of Health officials maintained this was “mainly due to the ongoing increase in the number of medical card holders”.
The Department officials said that in 2008 payments to GPs amounted to €465 million, in 2009 the figure was €472 million and €493 million in 2010.
The Department of Health note to the Minister also said GPs were unique among healthcare contractors in terms of the level and extent of allowances they received from the HSE towards their practice costs, “including generous subsidies towards the employment of practice nurses”.
It said there were no restrictions on the level of fees which GPs could charge private patients, the number of private patients they could see, or on their working hours.
“Thus GPs have the ability to offset reductions in their public income through increases in their private income,” it said.
