GPs have responded angrily to suggestions by Minister for Finance Brian Cowen that it was the "Government's entitlement" to introduce a doctor-only medical card scheme.
At the annual meeting of the Irish Medical Organisation (IMO) in Killarney, outgoing president Dr James Reilly, a GP in Lusk, Co Dublin, said Mr Cowen should be "mindful of the entitlement of the people of Ireland to have their Government's stated policy of delivering 200,000 medical cards honoured in full".
As tensions on the issue rose before Minister for Health Mary Harney's address today, the IMO said it had instructed its members not to co-operate with the introduction of the doctor-only medical card.
Dr Martin Daly, chairman of the GP committee, said the organisation had grave concerns about the reduced entitlements of people given the new type of medical card.
"In addition to paying for their drugs, families on €9 an hour and individuals earning €5 an hour will have no access to public health nursing, dental, clinical and ophthalmology clinics. In addition, patients will have to pay hospital and nursing home charges and they will have to pay for aid and appliances," he said.
Accusing Ms Harney of undermining the medical card system "in times of plenty", Dr Daly said it was not a money issue for doctors.
"The granting of full medical cards requires no additional payments to GPs. It is insulting for the Tánaiste to speak of a €25,000 payment per GP for changing the prescription paper they use. She represents this as a gift from the Government," he said.
"This money is payment for work done on a 365 days, 24 hours a day contract for people who have by virtue of their circumstances very high medical needs."
In a position paper on medical card eligibility published yesterday, the IMO called for increased income thresholds based on the national minimum wage. "The [ current] income threshold represents only 56 per cent of the current minimum wage of €273 a week," it said.
IMO data suggest the percentage of the population now covered by the medical card scheme is 28.3 per cent, which the group says is a further 1 per cent reduction in those eligible for free medical care.
Eithne Donnellan adds: Ms Harney indicated yesterday that in today's address she would speak to GPs about her plans for doctor-only medical cards as well as the need for innovation in healthcare generally.
She said the idea for the doctor-only card, which the IMO is boycotting, came from "leading members of the IMO. They were the first to suggest to me that this would be a good idea".
In Dublin Ms Harney stressed again there was no need for negotiations on the new cards as the only change it would mean for doctors was writing prescriptions on a different form. Doctors dispute this.