Parents of under-sixes face fees for out-of-hours GP
Parents face having to pay a private GP fee if they take their child to be seen in one of the doctors' co-ops which take over during evenings, nights and weekends, it has emerged.
If the doctor on duty has signed up to the new scheme giving free visits to under six-year-olds it will be free.
But if they have not, he or she can charge a private fee.
There are nine co-ops across the country and doctors who take part in these arrangements expect a surge in visits from around 6-8pm. These doctors often have to see children who are patients of another medic.
A spokesman for the Department of Health said yesterday it is expected parents will be given information in May on how to register with the HSE for free GP visits for their child under six, and this will continue until July when the scheme comes into effect.
It is still unclear how many of the country's 2,500 GPs will sign up to provide free GP visits for all under-sixes.
However, as revealed in the Irish Independent yesterday, GPs who have existing patients under six , covered by a medical card or GP visit card, will no longer be paid a State fee for them from July unless they sign up to the new contract.
The new contract offering free visits, asthma checks and wellness checks, takes over from existing agreements for this age group of children.
The knock-on effect is that the GP who refuses to sign up is likely to lose these under-sixes to another GP who has signed the new contract.
The number of patients under six varies per practice but it would have a serious impact on GPs in cities and towns in particular. There are currently around 166,000 under-sixes covered by a medical card or GP visit card. Another 237,000 who are currently private patients will be eligible for free GP visits for the first time under the new scheme.
If GPs were to lose their existing under six patients, for whom they are paid a State fee, they could also see practice grants they get for employing staff such as nurses affected as well as their pension.
Although GPs are self-employed and not direct public employees, they are uniquely part of a State-subsidised pension scheme if they hold a medical card contract.
All of the payments they will get for giving free GP visits to under-sixes will be pensionable.
The HSE deducts 5pc from each individual annual capitation fee a GP receives for each child and adult medical card patient on their books and puts it towards their personal pension scheme.
In addition to that sum, the HSE contributes 10pc of the total national cost of capitation fees for the medical card scheme annually towards the defined contribution pension scheme administered by the Irish Medical Organisation (IMO). The State contribution was €24.6m in 2013.
The IMO supports the new contract but rival union the National Association of General Practitioners (NAGP) is against it, saying the €67m fund should be spent on more needy children. The Disability Federation of Ireland said the under-sixes deal sidelined those with disabilities, including children, who already have a need to access their GP.
John Dolan, chief executive said: "This is a wrong decision. Free GP care needs to be introduced on medical need as opposed to age. Children and adults with disabilities should be given priority."
Earlier, Health Minister Leo Varadkar said more children and adults are qualifying for discretionary medical and GP visit cards. Some 81,000 now have a medical card and 20,000 a GP visit card on discretionary grounds, he added.