GPs unhappy with under-6s scheme told to retract protests

HSE refuses to allow ‘conditional’ acceptance of contract from doctors with concerns

Minister of State with responsibility for Primary Care Kathleen Lynch and Minister for Health Leo Varadkar at the launch of the online registration system for the free GP care for the under-6s scheme. Photograph: Gareth Chaney Collins
Minister of State with responsibility for Primary Care Kathleen Lynch and Minister for Health Leo Varadkar at the launch of the online registration system for the free GP care for the under-6s scheme. Photograph: Gareth Chaney Collins

GPs who signed up “under protest” to the new contract to provide free care for children aged under six have said they have been told by the HSE to write a letter of retraction before their application to join the scheme will be accepted.

The HSE refused to accept applications from doctors who appended a letter of protest, saying it could not accept a “conditional” acceptance of the contract from GPs.

Meath GP Ruairí Hanley described the development as "a new low" in Irish medical politics and called on Minister for Health Leo Varadkar to intervene.

“It appears that for our leaders it is not enough to merely persuade many GPs to sign up for under-6 care, but those with genuine concerns must also be humiliated in writing.”

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While Mr Hanley signed up and did not file a letter of protest, he said many of his colleagues did.

The scheme was introduced on July 1st with more than 2,000 GPs out of 2,400 contracted to the HSE signed up to it. More than 80,000 children have been registered by their parents for the free GP care.

Separately, the HSE is proceeding with the issuing of medical cards for under-18s, who have been diagnosed with cancer.

Many GPs who object to the under-6s scheme have decided to sign up anyway, fearing a loss of patients to rival doctors.

One GP told The Irish Times: "I was one of a significant number of GPs who deferred signing up to provide care under the scheme, knowing however that if the majority of GPs signed up, I too would have no option but to sign up in order to avoid risking the viability of my practice, my livelihood and my ability to provide for my family."

Pro forma letter

Many attached a letter of protest to their application form, outlining their objections to the scheme. Although some wrote their own letters, in most cases this was a pro forma letter drafted by the National Association of GPs, based on legal advice.

The letter claimed the scheme was “morally wrong” because scarce resources should be targeted to patients with the greatest needs rather than on age grounds. It said the signatory had major concerns about patient safety and would not accept responsibility for any “negative incidents” which occurred.

“I reluctantly signed this immoral contract despite the unimaginable damage this will do to primary care and patients’ wellbeing,” the pro forma letter concluded.

The HSE responded to the doctors in writing, saying it was not possible to accept their application “because of the conditional nature of your acceptance”. An official undertook to process the application on receipt of the contract “without the qualifications set out in your letter”.

A number of GPs said they then received a call from the HSE saying they had to write a letter “recanting” their protest before being allowed to sign up to the scheme.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.