Many GPs still undecided about free visits for children under six
The full rollout of free GP visits for all children under six from July remains uncertain - despite a promise that parents can start registering for the service online from early June.
The long-awaited scheme reached an important stage yesterday when it was announced that the contract, which 2,400 GPs are to be asked to sign if they want to offer the free visits, will be sent out this week.
Health Minister Leo Varadkar said: "I want to encourage all GPs to sign up to this new improved service which will ensure that from this summer, up to 270,000 children who currently pay their GP will no longer have to."
The GPs have two months to sign the contract in return for a yearly capitation fee from the HSE of €125 a year per child as well as other financial top-ups for asthma care.
From June, the HSE will launch a website which will let parents find out which GPs have signed up to the scheme.
They can then register their child with a doctor of their choice for free visits, which will also include two height and weight checks at the age of two and five.
However, it is unclear how many GPs will have signed by July. The National Association of General Practitioners (NAGP) said it is getting an independent analysis of the contract and this will take until August.
Its 1,200 GP members are being asked not to sign until it reports.
Confusion may also arise because of a deadline which may be imposed which will mean that GPs who already have children under the age of six on their books, who are covered by a medical card or GP card, risk losing them if they don't sign the new contract.
This is because the contacts the doctors currently have for these children will be overtaken by the new under-sixes contract.
This threat - first revealed in the Irish Independent - means that the children will no longer be entitled to free GP visits or medication if their parents choose to remain with a GP who has not signed up.
The National Association of General Practitioners warned it would go to the High Court if any of these contracts were removed from members.
The HSE said yesterday that any qualified GP can sign up for the new under-sixes scheme.
"GPs are independent contractors and it will be up to each doctor individually to decide whether they sign up for or opt out of this new arrangement.
"In addition to providing GP care for all under-sixes, the new contract will also include the provision of periodic wellness checks for children at age two and at age five, which are focused on health and wellbeing and disease prevention.
"GPs will be required to maintain a register of children under six with an asthma diagnosis and provide medical reviews."
The doctor will feed back data to the HSE - including information such as whether the child's parents smoke.
Dr Margaret O'Riordan of the Irish College of General Practitioners said it will review the contract in the coming days and consult the doctors.
She expressed concern about the increased demands the free visits will put on GP practices, and the impact this will have on other patients. It may mean not all patients will have "same day or next day" appointments, she added.
"Where a service is introduced free at the point of use, the international evidence supports the view that it is used more widely. Whether this will prove to be the case with this measure is unknown.
"However, what we can say is that general practitioners are stretched to capacity at present and any increase, however small, will have an impact on access to general practitioners for everyone. There will be some variation in this, depending on the patient population of the individual general practitioner."