Doctors and health service managers held more than 10 hours of talks at the Labour Relations Commission yesterday in an effort to prevent a further delay to the introduction of 200,000 "GP-only" medical cards.
Government plans to introduce the new cards, which would offer patients free medical care but not drugs or medicines, were first announced last November but have been held up by a row with the Irish Medical Organisation (IMO) which represents GPs.
IMO members voted last month to operate the new scheme on foot of a €93 million deal with the Health Service Executive on a range of outstanding issues, which was brokered by the Labour Relations Commission. However new difficulties arose within weeks of the ballot being carried.
A new sticking point is whether patients with a doctor-only card will receive a full medical card when they turn 70 and how much GPs will be paid for providing care in such circumstances.
Under current legislation, everyone over 70 is entitled to a full medical card, covering GP care and drugs, regardless of means.
Under a previous deal with the IMO, which led to the introduction of the medical cards for over- 70s, GPs were paid a higher than average annual capitation rate for providing treatment to patients coming under the scheme for the first time when they reached 70.
Patients who already had a medical card did not attract this special higher capitation rate.
The current capitation rate for treating a patient over 70 who previously had a medical card is about €135 per annum. The annual fee for a patient who received a medical card for the first time on the basis of reaching the age of 70 is about €480 per year.
It is understood the HSE opposes the payment of this special higher capitation rate for patients with doctor-only cards who reach the age of 70.