Top earning GP grossed nearly €800k in a year
THE top-earning doctor in the medical card scheme believes GPs like him who are working in deprived areas will need extra funds when the Government extends free care to everybody.
Dr Austin O'Carroll – a GP in Dublin's north inner city whose practice grossed nearly €800,000 in fees and allowances in a year – is one of almost 30 family doctors who received more than €300,000 in fees and allowances in 2012 under the scheme.
But he believes that higher fees will need to go to doctors working in poorer areas than colleagues in better-off regions, because people living in less well-off areas are "more prone to being sick".
Dr O'Carroll said he was in favour of the plan of free GP care for everybody but there were dangers if every doctor was paid the same state fee.
"If they pay every doctor the same fee it will divert resources away from poorer areas. There should be higher fees, which need to be directly used to hire more doctors and nurses," he told the Irish Independent.
He said there were eight other doctors in his practice and they looked after a panel of 2,500 medical card patients.
The income figures are also higher because of the service his team provide to the homeless in 11 outreach clinics.
Dr O'Carroll questioned the demand that under-sixes – due to be the first to get free GP care this summer – undergo a health check. He said there was no evidence to prove its benefits.
GPs with patients who are medical card holders were paid €351.09m in fees in 2012 and another €132.05m to cover some practice expenses such as the hiring of a nurse, the funding of study or annual leave.
The medical card scheme paid out €386.7m in fees and mark-ups to pharmacists for dispensing free drugs and another €1.6bn in drugs costs.
When the under-sixes are added to their books for free GP care from the summer, regardless of their parents' income, it will mean another 240,000 young people who were previously private patients will be paid for by the State.
Junior Health Minister Alex White said yesterday that despite strong opposition from doctors' organisations he believed there was potential for "good engagement" with them on the contract doctors would have to sign.
However, the discussions will exclude any negotiations on fees, which can only involve consultation with doctors due to competition law. It will be a matter for Health Minister James Reilly to set the fee.
Doctors have called for the draft contract to be scrapped, saying it puts such a burden on them that they would be working 70 hours a week and would be gagged from acting as whistleblowers.
However, Mr White said there would be face-to-face negotiations on the contract. He believed it would be possible to deliver the free care to under-sixes by June or July. "We will have negotiation on the contents of the contract," he said. "I have written to the IMO and I am awaiting their response."
Asked what he thought of a deal that would see the State pay more than €23m a year towards GPs' private pension scheme – even though they are self-employed – he said he was not in the business of "unpicking" arrangements that were made in the past.