Michael Harty (Clare, Independent) | Oireachtas source

I thank the Minister. I do not believe he appreciates the destruction the application of FEMPI is causing to general practice. It started in rural areas but now it is creeping into urban areas where it is impossible to attract GPs into the service. One of the principal reasons for that is the application of FEMPI. There has been a 38% reduction in the gross income of practices as a result of FEMPI. That is because the latter was applied to gross fees, not to the incomes of GPs. It is the gross fee which goes to support the structure of a general practice and not just the income of the GP. It has eroded the business model that has been sustained since the previous contract was agreed in 1972, some 46 years ago.

FEMPI has been unwound for all other public servants. There will be two pay increases this year and two next year but the Government has decided it will not unwind FEMPI for contract holders unless extra services are provided. It is tying that into the negotiations relating to the new contract. FEMPI was applied without negotiation but the Minister is using it as a stick with which to beat general practice in order to get the maximum out of the new contract. That is unprofessional.

The Minister must recognise the destruction FEMPI is causing to general practice. If he proposes to reform our health service, how can he expect it to be delivered if he does not have the GPs on which to build the foundation of a reorientation of health services from the hospital-centric scenario to a primary care model? The Minister must recognise - I do not believe he does - the destruction FEMPI is causing to general practice. He indicated that he has been speaking to GPs. He needs to engage with them. He needs to take charge of the negotiations because, in reality-----

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