Press Release

Reduction in fees paid to general practitioners and pharmacists

Minister for Health satisfied that the reductions are fair and reasonable

Today (2 July 2013), the Minister for Health, Dr. James Reilly TD, announced that he has decided to reduce the fees paid to general practitioners and pharmacists under the Financial Emergency Measures in the Public Interest (FEMPI) Act, 2009.

The Minister said “The decision was made following careful consideration of submissions made during the consultation process. The reductions will generate savings of up to €70 million in a full year. I am satisfied that the planned reductions are fair and reasonable and should not have an adverse effect on patient care and safety. Given that all public sector workers have taken significant pay reductions, it is only right and proper that GPs and pharmacists share the burden on our road to economic recovery”.

In the interests of proportionality, fees paid to dentists, optometrists and dispensing opticians who provide services to the HSE are not being reduced.

The main reductions are:

  • An overall reduction of 7.5% in fees and allowances paid to GPs, including:
    • a reduction in the weighting of patients over 70 years for the purposes of calculating State funding towards GP practice support subsidies from 3:1 to 2:1;
    • the removal of a special fee for GPs that was negotiated in 2001 when the State provided medical cards automatically to people over 70 years of age, a right which was removed in 2009;
    • reduction in the fee paid to GPs for administering the flu vaccination;
  • Removal of the 20% mark-up paid to pharmacists under the Drug Payment Scheme (DPS) and the Long Term Illness Scheme (LTI). The Minister’s expectation is that this reduction will be passed on to cash-paying patients.

Regulations are being made to give effect to the Minister’s decisions.

Details

General Practitioners

It has been decided to reduce GPs fees by 7.5%. Rather than an across the board cut of 7.5%, a strategic approach is being taken as follows:

Reduce the 3:1 weighting for patients over 70 years.

When the State originally provided medical cards to persons over 70 automatically, it was agreed that each 70 year old on a GPs list would count as the equivalent of 3 patients for the purposes of calculating State funding towards practice support subsidies.

The new change will require this to change to a weighting of 2:1.

Remove the special fee negotiated in 2001

When the State provided medical cards automatically to persons over 70, GPs negotiated a special payment to compensate for the loss of private patient income. In 2009 the automatic right for all persons over 70 was removed. It is now intended to remove the associated special fee paid to doctors.

Reduce the payment for the flu vaccine provided by doctors

The State pays pharmacists €15 for providing the flu vaccine. It is intended to bring the GP payment into line with pharmacists. The reduction is from €28.50 to €15.

Other fee reductions

In order to bring the overall reduction to 7.5%, the capitation and other superannuable fees will be reduced by 3.1%. There will also be some reductions in non superannuable fees.

These reductions will save an estimated €38 million in a full year.

Pharmacists

For pharmacists the reduction is accounted for by the removal of the retail mark-up for the Drug Payment Scheme (DPS) and the Long Term Illness Scheme (LTI). There has never been a retail mark-up for the GMS Scheme. Dispensing an item to a person under the DPS or the LTI involves no more effort than dispensing a similar item to a medical card holder.

The removal of the ‘mark-up’ is also in keeping with the recommendation of the ESRI that pharmacists should be compensated for dispensing a prescription on the basis of a professional dispensing fee only.

This change will result in savings of €32 million in a full year.

Other Reductions

Fees paid to Consultant Ophthalmologists who provide services to the HSE under the community schemes and to Consultant Psychiatrists who provide services to the Mental Health Commission will be reduced by 3%.

Notes to Editors

OECD Database (http://stats.oecd.org)

It is worth noting that the 2012 OECD database shows that self-employed GPs in Ireland top the annual income list (2009 figures) across OECD countries where data is available. Irish statistics to-date are based on figures supplied by the PCRS and do not include private income but do include payments such as practice supports towards the employment of practice nurses and secretaries. The 2013 OECD Database is due to be published shortly and it is understood that the Irish figures for GPs will be based on data supplied by the Office of the Revenue Commissioners. However, it is not expected that the position of Irish GPs vis-a-vis their OECD counterparts will change significantly.

Medical and GP Visit Cards

It is also worth noting that the number of medical cards has increased from by 391,536 from 1,478,560 at the end of 2009 to 1,870,096 at the end of April 2013 and the number of GP visit cards increased by 30,487 from 98,325 to 128,812 over the same period.