The Irish Medical Organisation (IMO) says it is 'appalled' at legislative proposals for the under sixes free GP scheme, published today by the Department of Health.
The proposals would effectively force GPs to sign up to a new under sixes contract by moving existing child medical card patients to the new scheme.
This means that child medical card patients whose GPs do not participate in the new scheme would have to find new doctors or else pay for treatment, as the GPs who do not sign up would not be able to hold on to their existing under six medical card patients.
Also, the families of child patients currently treated privately by their GPs would have to switch GPs in order to avail of free treatment, should their own GP not sign up to the new scheme. GPs who do not sign up would face a big drop in income through losing child medical card patients.
The doctors' union claims the Health (General Practitioner Service) Bill 2014 places 'draconian' restrictions on GPs which could 'destroy the very fabric of the GP service in Ireland'.
IMO GP Chairman Dr Ray Walley said it was clear that the proposed legislation had nothing to do with providing free GP care to children.
He said instead it was a unilateral attempt to replace the long-standing GP medical card contract with a new, draconian contract.
The IMO says the new contract as now proposed would institutionalise the provisions of emergency legislation (FEMPI) in regard to GPs, allowing the Minister for Health to unilaterally reduce, vary and change fees paid for GP services at any time.
The union also stressed that it would force GPs to move to the new contract by removing existing child GMS patients to the new scheme, and it would abolish the right of the IMO to negotiate on behalf of its GP members.
The Bill provides for the removal of children under six from the existing means-tested GP service under the medical card scheme and places them under new provisions for free GP care for all under sixes regardless of income.
This would in effect force GPs to agree to the new under sixes cover arrangements and provide consultations that would be free at the point of access to child patients that were previously fee-paying. Otherwise GPs stand to lose their existing under sixes patients covered by the medical card scheme.
The new arrangements would, the IMO said, also allow the Minister for Health to vary GP fees without any negotiation at any time.
Dr Walley said the new legislation would accelerate the departure of GPs from the Irish health services.
"On the one hand the Minister says he wants to talk to the IMO while on the other publishes legislation that appears to make talks a futile exercise."
The Bill stipulates that the Minister for Health may by regulation, with the consent of the Public Expenditure Minister, fix the fee and allowance rates paid to GPs.
It says the Minister will be required to enter into consultations on these payment rates.
The Bill says where the rates fixed by regulation are varied under subsequent regulations, a GP who does not wish to continue providing services may terminate their contract by giving the HSE three months notice.
GP organisations earlier this year rejected a draft contract for the under sixes plan as unworkable due to its restrucitons on how GPs would work. GPs have also been angered by the Government's insistence, now included in the Bill, that it cannot directly negotiate fees for the new scheme with the IMO, but can ultimately set the fees unilaterally after consultation.
Minister for Primary Care Alex White is due to address the IMO's AGM in Maynooth, Co. Kildare on Saturday.
Discussions on this topic are now closed.