Michael McGrath (Cork South Central, Fianna Fail) | Oireachtas source

I move amendment No. 46:

In page 58, between lines 8 and 9, to insert the following: "Medical practitioners operating in partnership

38.The Principal Act is amended, in Part 43, by the insertion of the following section after section 1008:

"1008A. (1) In this section⁠—

‘enactment’ means a statute or an instrument made under a power conferred by statute;

‘medical partnership’ means a partnership⁠—

(a) all of the partners of which are individuals who are medical practitioners, and

(b) that is governed by a partnership agreement;

‘medical practitioner’ has the same meaning as in the Medical Practitioners Act 2007;

‘partnership agreement’ means any valid written agreement of the partners governed by the law of the State and subject to the exclusive jurisdiction of the courts of the State as to the affairs of a partnership and the conduct of its business as may be amended, supplemented or restated from time to time;

‘relevant income’ means all amounts, in respect of relevant medical services, paid to, or for the benefit of, a relevant medical services provider, by the Health Service Executive;

‘relevant medical services’ means services provided by a medical practitioner pursuant to⁠—

(a) regulations made under sections 5 and 29 of the Health Act 1947,

(b) section 58 of the Health Act 1970,

(c) sections 62 and 63 of the Health Act 1970,

(d) section 62A of the Health Act 1970,

(e) section 67E of the Health Act 1970,

(f) section 70 of the Health Act 1970,

(g) orders made under section 75A of the Health Act 1970,

(h) regulations made under section 75B of the Health Act 1970,

(i) the Health (Amendment) Act 1996,

(j) the Mental Health Act 2001,

(k) the Redress for Women in Certain Institutions Act 2015,

(l) the Misuse of Drugs Acts 1977 to 2017,

(m) the Mother and Baby Institutions Payment Scheme Act 2023,

(n) Regulation (EC) No. 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems,

(o) the Trade and Cooperation Agreement between the European Union and the European Atomic Energy Community, of the one part, and the United Kingdom of Great Britain and Northern Ireland, of the other part, done at Brussels and London on 30 December 2020, and

(p) such other provisions of any other enactment as the Minister for Finance may by order prescribe;

‘relevant medical services provider’ means a medical practitioner with whom the Health Service Executive has entered into a contract to provide relevant medical services;

‘relevant payment’ has the same meaning as in section 520(1).

(2) (a) Where services are provided by medical practitioners which the Minister for Finance, following consultation with the Minister for Health, determines it would be appropriate to treat as relevant medical services for the purposes of this section, then, for those purposes, the Minister for Finance may, by order, prescribe the provisions of the enactment pursuant to which those services are provided.

(b) Every order made by the Minister for Finance under paragraph (a) shall be laid before Dáil Éireann as soon as may be after it is made and, if a resolution annulling the order is passed by Dáil Éireann within the next 21 days on which Dáil Éireann has sat after the order is laid before it, the order shall be annulled accordingly, but without prejudice to the validity of anything previously done thereunder.

(3) This section shall apply to a medical partnership where⁠—

(a) one, or more than one, partner in the medical partnership is a relevant medical services provider, and

(b) relevant medical services in respect of which one, or more than one, partner in the medical partnership is a relevant medical services provider are ordinarily provided by any medical practitioner who is a partner in, or employed by, that medical partnership.

(4) (a) A medical partnership to which this section applies and a relevant medical services provider who is a partner in the medical partnership may jointly elect to treat such proportion of the relevant income of that relevant medical services provider for the year of assessment as relates to relevant medical services that are, or may be, provided by any medical practitioner who is a partner in, or employed by, that medical partnership as income of that medical partnership for income tax purposes.

(b) The election made under paragraph (a) shall be in such form and manner as may be specified by the Revenue Commissioners.

(5) Where an election is made under subsection (4)⁠—

(a) for the purpose of section 1008, in calculating the amount of the profits or gains of the medical partnership concerned for a year of assessment, relevant income of a relevant medical services provider to whom the election relates, and any expenses laid out or expended for the purpose of earning that relevant income shall, subject to the provisions of the Tax Acts, be treated as if that relevant income was earned and those expenses were laid out or expended by that medical partnership in the course of its partnership trade,

(b) for the purposes of section 529A, each payment by the Health Service Executive to a relevant medical services provider to whom the election relates, in respect of relevant medical services, which is comprised within relevant income to which the election relates, shall be treated as⁠—

(i) a relevant payment to the medical partnership concerned, and

(ii) a payment in respect of a professional service that is provided in the conduct of the trade or profession of that medical partnership,

(c) the relevant medical services provider to whom the election relates shall furnish the tax number (within the meaning of section 524(2)) of the medical partnership concerned to the Health Service Executive and section 524 shall apply as if, in relation to each relevant payment by the Health Service Executive to that relevant medical services provider, in respect of relevant medical services, which is comprised within relevant income to which the election relates, that medical partnership is the specified person (within the meaning of section 520),

(d) the precedent partner of the medical partnership concerned shall include details of the relevant income to which the election relates in the return required to be delivered by that partner under section 880 for the relevant year of assessment, and

(e) the relevant medical services provider to whom the election relates shall, in the return required to be delivered by him or her under section 959I for a year of assessment⁠—

(i) confirm that an election under this section has been made in respect of the year of assessment, and

(ii) provide the name of the medical partnership to which the election relates.".".

My Department and Revenue have for some time been aware of issues arising from contractual arrangements within the general practitioner community whereby some GPs treat income received under their General Medical Services, GMS, contract as income of a GP practice in which they are a partner or an employee rather than income of that individual GP. However, under existing tax legislation, there is no legal basis for Revenue to treat income arising under a GMS contract entered into between an individual GP and the HSE as if it were income arising under a contract between the HSE and the medical practice in which the GP is a partner or an employee. A GP who holds a GMS contract is a chargeable person as regards income arising under the GMS contract and should report that income under the self-assessment system. The GP is also the specified person for the purposes of professional services withholding tax, which means he or she is entitled to claim a credit for such tax deducted by the HSE on GMS payments.

This amendment to introduces a new provision, section 1008A, into Part 43 of the Taxes Consolidation Act 1997. It provides that where individual GPs enter into contracts with the HSE to provide certain medical services and provide those services in the conduct of a partnership profession with other individual GPs, the income from those services can be treated for income tax purposes as that of the partnership. The amendment also provides that any professional services withholding tax credit may be claimed by the partnership under such instances. The partner who has the contract with the HSE, and not the precedent partner of the medical partnership, will provide the tax number of the medical partnership concerned to the HSE for the purposes of professional services withholding tax. This new provision will ensure that all amounts paid to, or for the benefit of, a GP by the HSE in respect of GMS and ancillary public services can be treated as income of the partnership. A joint election to treat the GMS and ancillary public services as income of the partnership must be made by the GP contracted by the HSE to provide the relevant medical services and the medical partnership concerned.

It should be noted that this proposed amendment is expected to resolve some, but not all, of the issues arising. This is because there are a number of business arrangements and models in the GP sector, including partnerships, companies, employees and employers. The core issue concerns the contractual arrangements involving GPs. The Minster for Health has confirmed that the strategic review of general practice, which is now under way, will examine the relevant HSE contracts and propose measures necessary to modernise them.

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