Alex White (Dublin South, Labour) | Oireachtas source

The Government's vision for primary care is the development of a single tier system in which access is based on medical need, rather than ability to pay. The Government is, therefore, committed to introducing a universal general practitioner service without fees, on a phased basis, in its term of office. The word "universal" has the meaning of applying to everybody and does not touch on the issue of how care is funded. It means simply that everyone has access. As such, the distinction drawn by the Deputy is incorrect. Perhaps we will return to that issue.

The orientation of health systems towards primary health care and general practice has advantages in terms of better population outcomes, improved equity, access and continuity of care and lower cost. As announced in the budget, the Government has decided to commence the roll-out of universal general practitioner services by providing all children under six years with access to a GP service without fees. The decision to commence the roll-out with this age cohort is in accordance with the recommendation in Right from the Start, the report of the expert advisory group on the early years strategy. Universal screening and surveillance services are already made available for children in this age cohort. Evidence suggests that a high quality primary care system with universal access will achieve better outcomes for young children.

The implementation of this measure will require primary legislation, which is expected to be published shortly. The necessary administrative arrangements will be made when the specifics of the legislation are known. The introduction of this service also requires a new contractual framework to be put in place between the Health Service Executive and individual general practitioners.

As Deputies are aware, a draft contract is currently the subject of a consultation process. In excess of 280 responses were received by the Health Service Executive during the consultation process. These responses are being examined and a report will be published in due course.

While there has been some negative reaction to the draft contract, I am pleased to say the Irish Medical Organisation, the primary representative body for general practitioners, has confirmed it is supportive of Government policy to introduce GP care free at the point of access, albeit conditional on the provision of adequate resources and full and meaningful negotiations with the IMO. I welcome this response and I have assured the IMO, most recently in my letter of 26 March, that the Department and the HSE are prepared to engage meaningfully with it in negotiations on all aspects of the scope and content of the proposed contract. I have also explained that there will be an opportunity for its input on the fee structure, which will be addressed by means of a complementary consultation process.

Additional Information not given on the floor of the House

I trust the IMO will accept my invitation to commence negotiations with the Department and the HSE. This will afford it the opportunity to obtain clarification from the Department and the HSE on any aspect of the draft contract and to raise any other issues which it may have in that regard. I am confident a process of open discussion has the potential to significantly enhance the draft contract for patients, GPs, the HSE and the Department, thus helping to progress our common goal of free GP care at the point of access.

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