Family doctors have been warned they will not get pay increases they believe are due to them unless they co-operate with plans by Minister for Health Mary Harney to introduce doctor-only medical cards.
The warning comes ahead of two days of what are likely to be tough negotiations between health service employers and the Irish Medical Organisation (IMO) under the auspices of the Labour Relations Commission next week.
The talks, to be held in Mullingar, are being convened to discuss a wide range of outstanding industrial relations issues including claims by the IMO, which represents the GPs, that doctors have not been paid 2 per cent pay rises on three separate occasions or included in a parallel benchmarking process, which they say they were promised.
Yesterday the chief executive of the Health Service Executive Employers Agency, Gerard Barry, confirmed employers were prepared to negotiate on these issues but he said that doctors, like other health service workers, would have to agree to modernisation and change before any pay rises would be agreed.
The agenda would include co- operating with the introduction of 200,000 doctor-only medical cards promised in the Budget.
Others issues, he said, were that employers wanted doctors to agree terms of reference for a "fundamental" review of their GMS (medical card) contracts.
Mr Barry said: "We cannot pay out pay increases to any group of people no strings attached. There has to be a trade off, and specifically we will require some concessions from the GPs in terms of service issues and in terms of modernising the service but we won't be setting the bar any higher than we set it for anybody else".
He emphasised no money would be paid to doctors specifically for their co-operation with the doctor-only cards.
Dr Martin Daly, chairman of the IMO's GP committee, said the employers had, at a recent meeting with the IMO, produced a document proposing a framework for settlement of all outstanding industrial relations issues at the LRC.
"They tied the doctor visit only cards to the possibility of GPs receiving an outstanding benchmarking award . . . the IMO always saw it as a separate issue but we hope that the fact that they have done so reflects a serious attempt on their part to settle this and other outstanding issues in relation to general practice," Dr Daly said.
He added that doctors in the IMO were concerned about reduced entitlements for people who receive the doctor-only medical cards - they will cover GP visits only but not drugs bills - but they accepted the Minister's entitlement to introduce them.
Notwithstanding this, comments by Ms Harney in recent days about changing the way in which eligibility for medical cards would be assessed had hampered negotiations, he claimed.
"She stated in the Dáil that childcare costs would be taken into account when assessing people for medical cards. This demonstrates a complete lack of understanding of how the system works," he said.
"People who can afford childcare are people who are usually well out of the reach of the income threshold for either a full medical card or the proposed doctor visit only cards.
"And if childcare costs were allowed to be introduced, in effect it would mean people who could afford to pay for childcare would be given precedence over people on very low incomes who cannot afford childcare," he added.
Ms Harney is likely to appeal again to GPs to co-operate with the introduction of doctor-only medical cards when she addresses the annual conference of the Irish College of General Practitioners in Galway today.