The way was finally cleared yesterday for the issuing of some 200,000 doctor-only medical cards promised by the Minister for Health Mary Harney to low-income families almost a year ago.
The Irish Medical Organisation (IMO), which represents GPs, agreed to allow them be handed out at eleventh hour Labour Relations Commission (LRC) talks yesterday afternoon.
Ms Harney had warned GPs if they didn't agree to the introduction of the cards before the end of this month they could forfeit a 9 per cent pay increase due to them under benchmarking.
The only issue which was in dispute between the IMO and the Health Service Executive Employers Agency (HSEEA), and which was holding up the introduction of the cards, was whether GPs should be paid higher fees for seeing holders of doctor-only medical cards once they reached the age of 70 and became entitled to full medical cards.
At present, GPs get paid 3½ times more for seeing patients who get medical cards for the first time, when they reach the age of 70, than they do for seeing patients over 70 who already had medical cards on reaching their 70th birthday. The IMO wanted GPs to be paid the higher rate for seeing holders of doctor-only medical cards when they reached the age of 70. Employers were refusing.
After two weeks of informal contacts between the chief executive of the LRC, Kieran Mulvey, and both sides in the dispute, the IMO agreed during 1½ hours of discussions at the LRC yesterday that the issue in dispute could be left in abeyance for the moment and that the cards could be issued.
It was agreed the matter would be considered in the context of a complete review of the GMS contract (GPs medical card contracts) which was previously agreed to and which will begin at the LRC next Tuesday.
It was also agreed if the matter cannot be finalised by next March, it will go to arbitration.
Gerard Barry, chief executive of the HSEEA, said GPs would now be paid benchmarking and other pay awards due to them, worth some €93 million. "I think everybody left the LRC today happy," he said.
Dr Martin Daly, chairman of the IMO GP committee, said the committee he represented had agreed before the LRC talks yesterday that the matter in dispute could be left over to be dealt with in the context of the GMS review.
He called on Ms Harney to take steps immediately to introduce the 30,000 full medical cards which she also promised last November but which have still not been handed out. "These full cards did not require any negotiation with the IMO and we are puzzled as to why they have not been introduced to date," he said.
Dr Daly said the IMO's decision to allow the introduction of doctor-only medical cards at this time had nothing to do with Ms Harney's threat in relation to benchmarking.
"Recent statements which were intended to put the IMO under pressure had the reverse effect, and it took considerable persuasion to talk many of our members down from escalating the disagreement we had with the Minister," he said.
News that a deal had been brokered was welcomed by the Health Service Executive and Ms Harney. HSE chief executive Prof Brendan Drumm said: "General practitioners are central to the reform programme and this agreement reflects their commitment to making it easier for the community to access healthcare."
Ms Harney urged people to apply immediately for the cards but she said the fact that one patient over 70 was worth more to a GP than a less well off patient was something she was not happy about and she wanted this discussed in the context of the GMS review.