Sinéad warns of pitfalls in free GP care for kids

There is a war brewing at the frontline of health services which could change the face of our healthcare for generations to come.

A new draft contract for family doctors has just been released which lays the groundwork for the government’s plan to grant free GP care to all children under six.

The Irish Medical Organisation (IMO) has slammed it as laughable. With no mention of fees – the Health Minister has indicated they are likely to be on the same scale as the current GMS or medical card scheme – the proposal, if put in place, will mark a fundamental shift in how GPs operate.

Whatever conditions are established for this initial scheme, they will form the basis for the government’s plan to roll out universal free GP care. And so the battle lines are drawn.

Under the new scheme, GPs would be required to carry out periodic wellness assessments.

The draft contract said the proposed scope of the service for young children is not limited to “diagnosis” and “treatment” but also includes participation by the doctor in active health promotion and disease surveillance, as well as prevention and appropriate management of chronic conditions.

With the GMS contract paying GPs an average payment of under €8 per month per patient with medical cards – and over €3 per child - regardless of how often they attend, GPs will fight against any contract requiring them to do more work for the same money. These fees are down by up to 40% after successive cuts.

“Making the figures balance every month is our biggest challenge,” opines Dr Sinéad Murphy.

“There are more and more cases of GPs [who own the practice] not getting paid. It’s happened to us. Some months we just can’t.”

You wouldn’t think sitting in the bright, harbourside surgery of Galway Bay Medical Centre– with a relaxing fish tank in the lobby and a corner in the waiting room replete with kids’ toys – that financial worries were an issue. It’s a very busy practice in the heart of town, managed by her husband Andy Taylor. It’s full of new mums and mums-to-be, city workers and the new Irish who have made Galway home. 

But the uncertainty around GP contracts is a source of very real stress for Dr Murphy, who set up the practice on Merchants Road five years ago. They moved in 2012 when they bought the building on the Docks which had been used as a solicitor’s office. It also allowed them the alternative name for the practice: Docs on the Docks.

Last year she had to return three months early from maternity leave because there wasn’t enough money coming in.

 Sinéad could have chosen a very different road. Her father, Dr Sean Murphy, wanted her to take over his practice in Portumna on his retirement.

“I worked there once a week. It’s a lovely practice, it’s rural, but in some ways it’s a lot more demanding. You’re so far from a hospital that the GP has to deal with a lot of trauma; you’re almost like a casualty, you’re dealing with violent deaths, suicides. You’re calling out to places on your own. I really wanted a city centre practice.”

For more, read this week’s Galway City Tribune.