Press Release

Minister Harney Announces Reductions In Fees Payable To Certain Health Professionalsl

The Minister for Health and Children today (Thursday 30 April 2009) announced reductions in the fees payable to certain health professionals in accordance with the provisions of the Financial Emergency Measures in the Public Interest Act, 2009.

The health professionals concerned include General Practitioners, Dentists, Pharmacists, Optometrists, Ophthalmologists and Dispensing Opticians who hold contracts with the HSE, doctors and others who take smears under the National Cervical Screening Programme and Psychiatrists who participate in the Mental Health Tribunal process.

In summary, the reductions of fee levels in respect of health professionals will be:

Profession 2009 reduction Full year value
GPs: 20m 34m
Dentists 1.5m 2.5m
Optometrists, Ophthalmologists and Dispensing Opticians 0.8m 1.1m
Smeartakers 0.63m 1.1m
Consultant Psychiatrists Acting for the Mental Health Commission 0.074m 0.11m
Total 23m 38.81

The Minister has not yet completed her deliberations in relation to pharmacists.

In accordance with the Act, the Department of Health & Children undertook a public consultation process. In addition, oral submissions were made by the main representative bodies for the professions including:-

  • Irish Medical Organisation
  • Irish Pharmacy Union
  • Irish Dental Association
  • Association of Optometrists Ireland
  • Irish Association of Dispensing Opticians

Submissions were examined by the Department in consultation with the Health Service Executive, the Mental Health Commission and the National Cancer Screening Board, as appropriate, and recommendations made to the Minister.

The Minister has now completed her consideration of the submissions and her Department’s recommendations in respect of all of the groups involved, other than Pharmacists. The outcome of her deliberations are summarised below.

Under the Act, the new fees are to be set by regulation made by the Minister with the consent of the Minister for Finance. It is expected that these will be made over the next few days.

General Practitioners

The Minister has decided to reduce by 8% most fees and allowances paid to GPs in respect of medical card and GP visit card holders, the Mother and Infant Care Scheme and the Primary Childhood Immunisation Scheme. The reductions in GPs fees are expected to yield €20m in the current year and €34 m in a full year.

Dentists

The Minister has decided to reduce professional fees paid to dentists under the HSE Dental Treatment Services Scheme. The reductions in these fees are expected to yield €1.5m in the current year and €2.5m in a full year.

Optometrists, Ophthalmologists and Dispensing Opticians

The Minister has decided to reduce professional fees paid to optometrists, ophthalmologists and dispensing opticians under the HSE Community Optometric Services and the Community Spectacle Dispensing Services Schemes. The Minister has also decided to reduce professional fees paid to ophthalmologists. The reductions in these fees are expected to yield €0.8m in the current year and € 1.1m in a full year

Smeartakers

The Minister has decided to reduce the fee payable to GPs and others who provide cervical smeartaking services to the National Cancer Screening Service (NCSS) under the CervicalCheck programme. The reduction is expected to yield €0.63m in the current year and € 1.1m in a full year.

Consultant Psychiatrists under the Mental Health Commission

The Minister has decided to reduce the fees paid to Consultant Psychiatrist/Mental Health Tribunal Members and Independent Consultant Psychiatrists by 8%. The reduction is expected to yield €0.074m in the current year and € 0.11m in a full year.

Pharmacists

The Minister has not yet completed her deliberations in relation to pharmacists because of the range and complexity of the various dispensing fees, mark-ups and re-imbursements which fall to be examined. However, it is expected that decisions with regard to Pharmacists will be made within the next two weeks.

The Government announced on 3rd February last that it intended to seek savings of €80 million on a full-year basis through a general reduction of the order of 8% in all professional fees, including those of health professionals. This was followed by the enactment of the Financial Emergency Measures in the Public Interest Act 2009

Section 9 (1) of the Act provides that: Section 9 (1) of the Act provides that: “The Minister for Health and Children may, with the consent of the Minister for Finance, by regulation, reduce, whether by formula or otherwise, the amount or the rate of payment to be made to health professionals, or classes of health professionals, in respect of any services that they render to or on behalf of a health body from the date of the regulation.”

General Practitioners

The Minister has decided to reduce by 8% the fees and allowances paid to GPs in respect of medical card and GP visit card holders.

In the case of medical card holders aged 70 years and over, the annual capitation fee is being reduced from €308.76 to € 284.07. Prior to the budget in October 2008 the capitation fee for a person aged 70 and over holding a non-means tested medical card was €640 per annum. This was reduced to €308.76 following Mr. Eddie Sullivan’s report and the application of increases due under Towards 2016. However, given the deterioration in the economic situation since then, the Minister considers that the over 70s fee must be reduced by a further 8%.

The Minister has also decided to reduce by 8% the special capitation payment of almost €974 per annum paid to GPs in respect of medical card holders aged 70 and over residing in private nursing homes. The new annual fee will be € 899.83.

There will also be an 8% reduction in other fees and allowances under the GMS scheme, including Practice Secretary, Nurse and Manager allowances.

The Minister has decided to reduce by 8% the fees payable under the Mother and Infant Care Scheme, the Primary Childhood Immunisation Scheme and the Health (Amendment) Act 1996.

There will be no reduction in Medical Indemnity Insurance payments ( which are paid by the HSE on the basis of vouched claims from GPs.), in GP trainers/trainees rota fees or in fees under the Methadone Treatment Scheme.

The reductions in GPs fees are expected to yield €20m in the current year and €34 m in a full year.

Dentists

Dentists in private practice provide dental services to medical card holders on behalf of the HSE under the Dental Treatment Services Scheme (DTSS). A separate scheme – the Dental Treatment Benefit Scheme (DTBS) – is operated by the Department of Social and Family Affairs in respect of insured persons.

Payments to Dentists consist of two elements – a professional fee and an amount in respect of materials e.g. dentures. The Minister has decided that she will not reduce that part of the fee which relates to materials. The Minister also has decided to apply an outstanding fee adjustment and to reduce the resulting fees by 8%. Accordingly, the reduction in Dentists fees will on average be of the order of 4.5 %.

The reductions in Dentists fees are expected to yield €1.5m in the current year and €2.5 m in a full year.

Optometrists and Dispensing Opticians

Optometrists and Dispensing Opticians provide eye examination services to adults and in some cases children under the Community Optometric Services and the Community Spectacle Dispensing Services Schemes. They may also supply spectacles and contact lenses, as appropriate.

Payments made to Optometrists and Dispensing consist of two elements – a professional fee and an amount in respect of materials e.g. frames, lens etc. The Minister has decided that she will not reduce the part of the fee which relates to materials. The Minister also has decided to apply an outstanding fee adjustment and to reduce the resulting fees by 8%. Accordingly, the reduction in Optometrists and Dispensing Opticians fees will on average be of the order of 3.6%.

Ophthalmologists

Ophthalmologists hold contracts with the HSE to deliver services to eligible persons for the provision of Medical Eye Examinations and the provision of Spectacles and Contact Lenses. In addition a small number of ophthalmologists have an agreement with the HSE to provide minor surgical eye treatments under a pilot scheme. The Minister has decided that a reduction of 8% will apply to the fee element of payments made to ophthalmologists under these Schemes.

The reductions in Optometrists, Dispensing Opticians and Ophthalmologists fees are expected to yield almost €0.8m in the current year and about € 1.1 m in a full year.

Smeartakers

A large number of GPs and others (e.g. family planning clinics) providing cervical smeartaking services to the National Cancer Screening Service (NCSS) under the CervicalCheck programme. A fee of €56.18 is payable in respect of each smear taken and the Minister has decided to reduce this by 8% to € 51.69.

The reduction in the Smeartakers fee is expected to yield €0.63m in the current year and € 1.1m in a full year.

Consultant Psychiatrists under the Mental Health Commission

The Mental Health Act 2001 provides for the automatic review of involuntary admissions to psychiatric hospitals. Fees are paid by the Mental Health Commission to Consultant Psychiatrists who sit on Mental Health Tribunals to review detentions and to Independent Consultant Psychiatrists.

The Minister has decided to apply an outstanding fee adjustment and to reduce the resulting fees by 8%. The new fees will be € 428 for Consultant Psychiatrist/Tribunal Members and Independent Consultant Psychiatrists for € 535 per case.

The reduction in Psychiatrists fees are expected to yield €0.074m in the current year and € 0.11m in a full year.