Top 100 earning GP practices and co-ops shared €50m in 2014

Three GP co-operatives topped list of highest earners with HSE payments of more than €1m

Doctors’ organisations argue the payments do not take into account practice expenses and overheads and therefore do not represent income for individual GPs.  Photograph: PA
Doctors’ organisations argue the payments do not take into account practice expenses and overheads and therefore do not represent income for individual GPs. Photograph: PA

The State's 100 top-earning GP practices and co-operatives shared gross payments of almost €50 million from the HSE during 2014, according to the latest figures.

Twenty GP practices and co-operatives received payments of more than €500,000 from the Health Service Executive (HSE) last year for their participation in the medical card and other State primary healthcare schemes.

The Irish Medical Organisation (IMO) said the earnings figures were "completely misleading and designed to distract attention from a very real crisis in GP services right across the country".

It said the figures released by the HSE did not represent the salaries payable to GPs.

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“Before the GP is paid a single cent out of this income they must first pay a range of business expenses including staff costs (other doctors, nurses and administrative staff) rent, rates, light and heat, IT infrastructure, commercial and medical insurance, vital and expensive medical equipment and more,” the IMO said. “The GP is the last to receive a payment from these monies. And despite some of the dramatic headlines these create, the fact remains that a GP receives an average of just €10 per month per GMS patient regardless of how often that patient attends the GP. “

Three GP co-operatives topped the list of highest earners. Each received payments of more than €1 million from the HSE last year.

Excluding co-operatives, the highest-earning individually- named GP was Dr Austin O’Carroll, whose practice in Dublin city was paid €757,613 in fees and allowances by the HSE.

He is one of around nine doctors working in his Dublin practice.

The highest recipient in 2014 was Care Doc, which is an out-of-hours doctor service operating in Carlow and Killkenny.

It was paid €2,570,768 by the HSE under the various medical schemes.

Care Doc is the business name of Carlow Emergency Doctors on Call Limited, which reported a total income of nearly €14,786,196 in the most recent accounts filed to the Companies Office.

The next-highest beneficiary under the schemes was North Doc Medical Services, which provides an out-of-hours service for patients in North Dublin. It received €1,624,066 from the HSE and reported total income of €2,978,163 last year.

North East Doctor on Call (NEDOC) Limited was third on the list of top-earning practices, receiving €1,282,922 from the HSE for its participating in the schemes. The company’s accounts for 2014 report a total income of €2,731,181.

Kildare and West Wicklow Doctors on Call (KDOC) was paid €994,068 by the HSE last year, and reported total income of €3,947,167 in its accounts for the same period.

The figures were released by the HSE earlier in response to a parliamentary question tabled by fine Gaed TD Brian Walsh.

Under the General Medical Services contract, participating GPs receive a range of fees and allowances in respect of each medical card and GP-visit card patient on their list.

Annual capitation payments are made to GPs regardless of whether or how often a patient visits their doctor during the year. Other grants are paid in respect of practice expenses, study and annual leave.

The IMO said general practice was struggling to deliver existing services to patients. It said GPs were expected to treat more and more patients with less and less resources.

The doctors’ tradeunion said that while there was great potential to deliver a whole range of additional services, including chronic care, this could only happen in the context of a new GP contract.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.