Tuesday 19 November 2019

Doctor launches action against HSE over plan to give free GP care to children under six

The Four Courts
The Four Courts

Aodhan O'Faolain & Ray Managh

A medical doctor has launched a High Court action against the HSE's arising out of its plans to provide free GP services to children under six years of age.

In what is regarded as an important test action Co Clare based Dr Yvonne Williams wants the introduction of the new scheme postponed until her representative body, the National Association of General Practioners (NAGP), has an opportunity to negotiate the scheme on  behalf of its members. 

It is claimed the proposed scheme, which is due to come into effect in July,  to provide free health care to all children under the age of six years will result in changes to Dr William's General Medical Services (GMS) contract with the HSE.

The GMS contract is the agreement between GPs and the HSE for the delivery of primary care services to medical card holders. 

She claims the changes to her GMS contract are being imposed on her unilaterally.

She also says the exclusion of the NAGP from the negotiation of the new contract has "gravely prejudiced" her.  Her action is being supported by the NAGP, which claims the HSE has acted in breach of contract.

In a sworn statement ground her application Dr Williams, represented by Eanna Mulloy SC and Phelim O'Neill solicitors said that under the new scheme will lead to a "dramatic increase" in the frequency which the under sixes will present at her practice.

She said it would "not be possible to accommodate the increased demand" and to try to do so would "compromise the care of all her patients." It would be "profoundly unethical" for her to enter into the new contract with the HSE.

She also fears if she were to refuse to sign she would put the future of her practice in jeopardy. If she did not sign the parents of her under six patients that have medical cards would move to "whatever practice the HSE assigned their children to."

In addition private patients under the age of six years would also leave her practice "to avail of free treatment elsewhere."

Dr Williams said she was being placed in "an impossible position" of either signing a new contract which she believes will compromise her patient's care or face having to close her practice.

Through her solicitors she asked the HSE to postpone the introduction of the new scheme, but they have failed to do so.

As a result she has launched High Court proceedings seeking injunctions including one restraining the HSE from removing any patients under the age of six from her GMS list until the proceedings are determined.

She also seeks orders restraining the defendant from reducing payments due to her under her GMS contract.

Today, Mr Justice Anthony Hunt granted Dr Williams, a GP based in Shannon Co Clare, permission to serve short notice of the proceedings against the HSE. The application was made ex-parte, where only one side was represented in court.

The Judge made the matter returnable to Wednesday of next week.

In a sworn statement to the court supporting Dr William's action NAGP'c Chairman Andrew Jordan said the organisation, which has 1281 members, has been "willfully excluded" from talks concerning the under-6 scheme and changes to the GMS scheme.

He said the HSE and the Minister for Health had engaged with the Irish Medical Organisation about the proposed new scheme.

This was to the exclusion of "a significant general mass of the GPs," and this "selective" action has had "a profound impact on the rights of members of the NAGP," he said.

It was announced last April the HSE, IMO and the Minister reached an agreement in relation to the under 6's scheme. As a result of its excuslion the NAGP said it has had to rely on media reports for information about the scheme, Mr Jordan said.

It is the NAGP's position any unilateral alternation of the its members GMS contracts would be regarded as a "fundamental breach of contract".

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