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Friday 23 February 2018

IMO to suspend withdrawal of GP services pending court action

Tim Healy

THE Irish Medical Organisation (IMO) has undertaken before the High Court to suspend, pending the outcome of legal proceedings,  plans by its GP members to withdraw from certain services in protest at new fee cuts.

In order to ensure a speedy hearing of the full case, the IMO also undertook to remove from the IMO website a July 10th press release announcing that withdrawal decision and to inform its members of its  undertaking within two days.

The undertaking applies pending the outcome of a full hearing of proceedings in which the Competition Authority alleges the planned withdrawal, announded on July 8th,  is in breach of competition law.

Douglas Clarke, for the IMO, told Mr Justice John Cooke today the undertaking is without prejudice to his side's defence of those proceedings which, he stressed,  would be "fully defended".  The IMO regarded the Authority's claims as "misplaced", he added.

Counsel said the IMO had decided to provide the undertakings rather than get immersed in a possibly protracted heraing of the Authorty's applicaiton for injunctions, to apply pending the full hearing, aimed at preventing the GPs withdrawing until the court had decided the matter.

When the injunction application came before Mr Justice Cooke earlier, Michael Cush SC, also for the IMO, and Niamh Hyland SC, for the Authority, indicated there were discussions between the sides.  The agreement which resulted in the undetrakings was put before the judge about two hours later with the effect the injunction application did not proceed.

The judge also approved directions agreed between the sides for the exchange of pre-trial legal documents and returned the matter for further direcitons to October 29th.

Ms Hyland indicated her side may call evidence from economists as to the economic impact of the proposed withdrawal and the Authority's claims it would distort competition.

The Authority previously set a deadline of midday on Monday last week for the IMO to publish an undertaking to reverse its planned action. After that deadline, it received correspondence from the IMO’s solicitors saying that would not be forthcoming.

That led to the Authority filed proceedings. In its action, the Authority claims the IMO’s decision of July 8th last to withdraw the relevant services with a view to preventing the Minister for Health reducing the fees payable under the GMS contract is prohibited under both Irish and EU competition law.

The IMO move came after the Minister for Health, James Reilly,  announced further cuts in payments to GPs of about 7.5 per cent on average under financial emergency legislation.

The IMO held an emergency meeting about that after which it said its GPs members would withdraw from primary care teams, community intervention teams and clinical care programmes for chronic diseases. It also said it would pull out of any work not covered under the terms of their contract with the HSE.

In a statement previously, the Competition Authority said it believed the proposed withdrawal of the relevant services was directly linked to the decision of the Government to cut fees paid to GPs.

Withdrawing services, regardless of claims they may be free or pro bono, is viewed as an attempt to directly or indirectly fix the fees paid to GPs by the Government under the GMS contract, the Authority said.

“Self-employed GPs are subject to competition law, as they are private businesses, unlike employees who may act collectively, represented by a union and are not subject to competition law.”

In a statement after today's hearing, the IMO said allowing GPs the right to be represented by their trade union in their negotiations with Government on services covered by the medical card and other services for public patients "is a matter of fairness and logic" and it would "vigorously defend" its position at a full hearing.”

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