FAMILY doctors are earning up to €650,000 a year for the care of patients under the medical card and other state schemes – despite complaining about cuts in fees.
New figures show a high proportion of doctors are grossing significant income from the schemes, particularly those with large panels of medical cardholders.
The highest earners in 2011 were two practices in Dublin south-west, each of which received €650,000, while a doctor in Kerry got €616,019 from the schemes.
The HSE has not released the names of the doctors or pharmacists involved even though the payments were made two years ago.
The doctors receive a yearly capitation fee per patient and also get other allowances and payments for services, such as vaccinating children, as well as financial assistance to employ a practice nurse.
Some 23 GPs earned over €470,000 – down from 51 in 2010. Another 698 received more than €240,000.
The numbers in the €120,000 to €210,000 earning bracket went up in 2011, according to the HSE report.
The doctors insist that these earnings can cover a number of GPs in a particular surgery and they have to subsidise overheads.
All the doctors can also see private patients and the average family doctor fee is now around €60. However, no figures are available for this private income.
Pharmacists also received over €358m in fees and mark-ups for drugs and medicines dispensed to medical card and private patients. One pharmacist got more than €240,000.
The recession has seen the number of people who qualify for a medical card soar and around half the population are now covered by the scheme.
This has meant that many healthy people are qualifying for a medical card but the doctor continues to receive a capitation fee.
Around 20,000 people over 70 are to lose their full medical card, although most will still get free doctor care through a GP visit card.
Those who lose the medical card will be people over the age of 70 with a weekly income of €600-€700 or €1,200-€1,400 for a couple.
The Irish Medical Organisation, which represents GPs, has warned that if another €70m is cut from their fees for treating medical cardholders this year it will "decimate the capacity" of general practice.
The availability of house calls and other supports to nursing homes will be considerably reduced, impacting on the most vulnerable patients, it claimed.
Dr Ray Walley, the GP spokesman for the IMO, predicted that the cuts may lead to reduced hours of services and increased referral of patients to hospital by ambulance.
GPs are also finding it increasingly difficult to get locums to cover for them when they are away or not on duty.