FAMILY doctor Kevin Kelly said he is one of the GPs who will not be signing up to give free care to children under six.
Dr Kelly, of the Western House Medical Centre in Clonmel in Co Tipperary, said he could not tolerate a situation where he was checking the height and weight of a healthy child, as part of the scheme's planned compulsory annual health check, while one of his sickest patients was left waiting.
"I also think it is immoral to be taking medical cards off ill people and giving them to my children when I am more than capable of paying for their care.
"I can't take the under-sixes scheme on. I would lose my ability to provide a service."
His practice has seven doctors and a panel of around 1,100 medical card patients. The practice generates a gross income from the state scheme of around €1m annually, but he said most of it went on costs, including a substantial mortgage.
"There are 22 families taking income from the practice," he added.
He took issue with figures quoted by Health Minister James Reilly on GPs' income from the medical card scheme.
"The average panel of medical card patients is not 1,000 but 800. The average cost to the State per patient under the scheme in 2008 was €323, and in 2012 it was €200," he said.
He believes that the sapping of morale among GPs is the most serious issue. Their trust and belief in the system has been shattered, and it will "take years to re-establish".
"If you look at the demographic at any GP meeting, they are grey, tired old men. It is only a place for old men and ladies.
"No GPs who trained in the Galway scheme last year remain in general practice in Ireland. The risks of a reduction in the numbers of GPs in Ireland cannot be overstated."
Around 30pc of existing GPs will retire within the next 15 years, creating a bleak outlook for Irish healthcare.
Dr Kelly added: "The costs and efforts involved in repairing this damage to general practice will be immense."