GPs are expected to get a substantial boost to their personal pensions if they sign up to providing free care to children under six in return for an annual state fee later this year.
Figures obtained by the Irish Independent reveal the Health Service Executive (HSE) paid out a staggering €24.6m last year into a private pension scheme for GPs who treat medical card holders.
The pension deal, which involves substantial payments from the taxpayer, is unique because GPs are not direct employees of the State but are self-employed contractors who can opt in or out of treating medical card holders.
The GPs are expected to get around the same annual capitation fees from the State for providing free care to 240,000 children under six as they receive for a child of similar age covered by a medical card.
This is also expected to 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.
And 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 doctors' union.
This 10pc contribution has risen from €23.7m in 2011 to €24.6m last year.
Doctors get €75 a year for young children and €43 for five-year-olds who are in the medical card scheme regardless of how often they visit. Both of these fees are pensionable. Top-earning GPs gross over €300,000 annually in capitation fees.
The lucrative pension deal for GPs was worked out with the Department of Health in the 1990s by the late IMO GP president Dr Cormac MacNamara.
At the time, he argued that too many GPs were working into their 70s and 80s because they had not made provision for their retirement.
Health Minister James Reilly, who had a large panel of medical card patients as a GP before entering politics in 2007, will be entitled to a pension under the scheme.
The pension "sweetener" is expected to be part of the package to persuade GPs to sign up for the first phase of free GP care later this year, despite their strong opposition to the draft contract they may be asked to sign.
The IMO said the proposed contract was unworkable and would place a huge burden on GPs.
The Irish College of General Practitioners also warned it would mean that GPs would end up working 70-hour weeks.
The minister has already told the Joint Oireachtas Committee on Health and Children that he cannot see GPs refusing to treat under-sixes in return for state fees.
"They have no reason to refuse them because the pay on offer is what is currently available. As I have often said, research reveals that 1,000 medical card patients are worth €250,000 to a GP when we consider the ancillary benefits."
Apart from the pension contributions, the GPs who treat medical card patients get paid study leave, holiday pay, nursing grants and secretarial grants.