THE DEPARTMENT of Health and the HSE are to examine claims made by doctors that some fee cuts introduced over the past year or so have had a disproportionate impact on rural GPs.
The Department of Health and the HSE are to look in particular at the decision to remove the “distance from the GP’s surgery” from the calculation of capitation fees paid under the general medical services scheme.
The commitment to examine this issue is set out in the findings of the official Department of Heath review of regulations which reduced fee rates for health professionals such as GPs, community pharmacists and dentists delivering services to or on behalf of the HSE.
The Department of Health review, which has been seen by The Irish Times, recommended the fee reductions put in place under the Government's financial emergency legislation be maintained.
The findings were approved by the Minister for Health, James Reilly, just before Christmas.
The regulations will be reviewed again later this year under the provisions of the financial emergency legislation.
In its submission to the review, the Irish Medical Organisation (IMO) said the agreed methodology for calculating professional fees using age, gender and distance had been designed to ensure those patients listed in the various categories would receive the optimum care and attention during visits to and from their GPs.
“Of the €46 million removed under the recent FEMPI [financial emergency] legislation, change to distance coding accounts for 10 per cent and a reduction in monetary terms of €4.5 million.
“These reductions continue to have a serious detrimental effect on the ability of general practitioners to provide and sustain the full range of patient care.
“The removal of ‘distance from a GP’s surgery’ as a factor in calculating capitation fees had a negative effect on all GPs but it has had a disproportionate and inequitable effect on those GPs based in rural and remote areas as a consequence of their location and the geographic spread of their patients.”
The IMO said the capitation rate payable in respect of a male patient aged between 16 and 44 years fell by 28.5 per cent between September 2008 and December 2010 – down from €79.73 to €57.03.
The IMO said inequalities were further highlighted in examining the cases of GPs dealing with a female patient aged between 65 and 69 years in both rural and urban areas.
It said in the case of the patient based more than 10 miles from the surgery, the GP’s capitation fee fell by 44.5 per cent, down from €241.44 in September 2008 to €133.87 in December, 2010.
However, the IMO said in the same period the fee for the urban doctor treating the same category of patient was reduced by 10.5 per cent.
