IMO conference: The Minister for Health, Mary Harney, firmly rejected GPs' arguments against the introduction of a doctor-only medical card when she addressed the annual meeting of the IMO yesterday.
She predicted patients would not thank their doctors for continuing to charge for medical consultations at a time when the Government wanted to offer an additional 200,000 people free GP care.
However, her contention that the idea for the doctor-only medical card had come from "a leading member of the IMO" was denied by the organisation last night.
While Ms Harney said the proposal had been put forward by a prominent family doctor at a meeting two weeks before her appointment as Minister for Health last September, the IMO categorically denied that this was the case.
Responding to Ms Harney's remarks, the vice-chairman of the IMO's GP committee, Dr Ronan Boland, said last night that "none of the senior GP personnel in the IMO with the authority to make such suggestions to the Minister did so".
Ms Harney also suggested that doctors should operate the medical card system while negotiations took place on the issue, but this was angrily rejected by GPs at the meeting.
"This is a workload issue and not a money issue," a GP negotiator said. "The introduction of a separate category of medical card will mean a huge increase in workload because of the proposed eligibility guidelines."
Another prominent family doctor said the Minister's proposals were aimed at altering the conditions of the general medical scheme without providing the resources for GPs to provide additional services for their patients.
Doctors also warned that the new system could destabilise out-of-hours care by increasing the workload on GP co-ops.
Ms Harney said in her address to the meeting: "I like the concept of graduated benefits [provided by the new type of medical card]. I think it is fairer. The doctor-only cards allow four times as many people to benefit than would otherwise be the case."
She also warned that a failure to confront change means that both patients and doctors suffer.
Calling on all doctors to actively engage in the health service reform process, Ms Harney said the amount of money spent on healthcare in the Republic compared well with other countries. "At €3,000 per capita, we spend 7 per cent more in real terms than the Blair government in Britain. This is 9 per cent per capita more than the Germans and 70 per cent more than the Italians. Only Denmark and Luxembourg are ahead of us."
Turning to the role of the private sector in the health system, the Minister said not all additional investment in health should come from the State.
"I will shortly be issuing a framework for private investment in public service facilities," she said, adding that under such schemes public patients will be guaranteed the same access as private patients.
She told doctors she expected to appoint a new chief executive of the Health Service Executive in two weeks. There was speculation last night that the post has been offered to a leading academic doctor from a Dublin medical school.
Asked when she would formally announce the location of the two new radiotherapy services for Dublin, Ms Harney said she planned to meet with the author of the Hollywood report, Prof Donal Hollywood, in the coming weeks.
She indicated that she had already made a decision on the location of the radiotherapy units. An independent review group has recommended the new facilities be located at St James's Hospital and Beaumont Hospital.