Press Release

Government Accepts Recommendation on €290 Single Fee to GPs for Medical Card Holders Aged 70 and Over

The Minister for Health and Children, Ms Mary Harney T.D., today(Wednesday 29th October) announced that the Government have accepted the recommendation by Mr Eddie Sullivan to pay general practitioners (GPs) a single capitation fee of €290 in respect of all persons aged 70 and over who will have a medical card after implementation of the Budget decision to end the automatic medical card entitlement.

Mr. Sullivan, a former Secretary General and current chairperson of the Public Appointments Service, was asked to recommend for consideration by the Minister for Health and Children and the Government a new capitation rate for participating doctors in the medical card scheme that would be payable in respect of all patients aged 70 and over in the community without distinction as to status.

In framing his recommendation, Mr Sullivan had regard to more than 70 submissions received by him from interested parties, including the Irish Medical Organisation and the Health Service Executive.

Mr Sullivan’s report was considered by the Cabinet at its meeting this morning. The Government accepted his recommendation and approved the publication of his report.

Currently, GPs are paid a capitation fee of €640 in respect of persons aged 70 and over who receive a medical card automatically on age grounds, compared with an average fee of €162 for persons in that age category who obtained a medical card on the basis of a means test. The implementation of Mr Sullivan’s recommendation means that, subject to the proposed legislative changes, from the 1st January 2009, GPs will receive a single fee of €290 for all medical card holders aged 70 and over.

As with the existing special capitation rate of €640, the revised rate of €290 excludes a €3.89 supplementary out-of-hours fee. This, and all other capitation fees, fall to be increased by the two 2.5% increases due under Towards 2016.

It is estimated that the revised single fee will generate savings of about €16 million next year in capitation fees paid to GPs. Mr Sullivan indicates in his report that the new single rate will mean increases in overall fee income for some GPs and a reduction for others, depending on practice mix.

The ending of automatic entitlement to a medical card will give rise to further savings of approximately €20 million in 2009.

The Minister said, “I want to reiterate that, in a very difficult economic environment, the Government are implementing decisions that are aimed at a fair and sustainable use of scarce taxpayers’ resources. These decisions form part of a series of budgets that are needed to return the country to economic growth, with sustainable financing of public services.

“I very much welcome, therefore, the recommendation on a single fee for all doctors for all patients aged 70 and over with medical cards. The unintended inequity in the present arrangements, whereby different GP practices receive different fees for the same number of patients over 70, will end. The new fee will represent a better balance between all GP practices and, therefore, balance between all patients aged 70 and over.

“The Government’s Budget decisions remain in place. First, resources for health are to be used to sustain services and to support those most in need; consequently, the principle of ending the automatic entitlement to a medical card for persons aged 70 and over will be implemented.

“I note Mr Sullivan’s report highlights that the growth in automatic medical cards has been more than twice that of total medical cards among people aged 70 and over. This is not sustainable in the economic context we face in the coming years.

“Second, the savings of €100 million in this area are to be achieved. The balance of the total savings of €100m required by the budgetary framework will be achieved through economies in drug usage, based on recommendations from a group being established under the chairmanship of Dr Michael Barry.

“I welcome the fact that, in its submission to Mr Sullivan, the IMO has identified savings of €80m that could achieved in drugs costs.

“Dr Barry’s group has been asked to report by 1st December next. Decisions on implementing the group’s recommendations will be taken quickly after Dr Barry reports, in order to allow the existing and new resources within the health budget to be applied as planned. It is vital for planned service developments in cancer and services for children with disabilities, and supporting those most in need of medical cards, that the savings are achieved as planned.

“In the meantime, I can confirm that work is underway between the Departments of Health & Children and Enterprise, Trade & Employment on the issue of amending Section 4 of the Competition Act 2002, in a manner consistent with EU competition law and national policy. Proposals will be submitted to the Government in due course.

“Finally, the Government are deeply grateful to Mr Sullivan for completing his task within the short timeframe available to him. We are also grateful to those who made submissions at short notice.”

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