Mary White (Fianna Fail)
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I welcome the Minister of State at the Department of Health and Children, Deputy Seán Power, to the House. He will remember that I raised this matter yesterday, initially on the Order of Business. Dr. Patricia Comer, a Dublin GP, will not be allowed to treat her 500 medical card patients when she turns 70 in August this year. There is no reason for this other than her age. That Dr. Comer can continue treating private patients after August this year compares starkly with the fact that she cannot treat public patients due to nothing other than ageism.

Almost all of Dr. Comer's 500 medical card patients are older people who have built up great relationships with Dr. Comer over the years. She has treated their children and grandchildren. Older people are understandably distressed at being forced to change doctors having been served so brilliantly by Dr. Comer for more than 40 years. I understand that the Irish Medical Organisation has insisted on an age limit of 70 years as a protection mechanism to ensure that younger doctors will have general medical services scheme jobs available for them. However, as insufficient newly-trained GPs are available to take up these positions, the protection policy should not continue to exist. Younger doctors are prone to cherry-pick work locations and some are only interested in working part-time when appointed.

James Bannon (Fine Gael)
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It is wrong to say that about young doctors.

Mary White (Fianna Fail)
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I am entitled to say what I like. The Senator does not know what he is talking about. I have studied the matter.

Paddy Burke (Fine Gael)
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I remind Senator Bannon that this is Senator White's motion.

Mary White (Fianna Fail)
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Rather than the Minister of State explaining why such ageism exists, I want to know what he plans to do as a matter of urgency. There is an overwhelming obligation on Government to stamp out ageism in all its forms.

Seán Power (Kildare South, Fianna Fail)
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I thank the Senator for raising the issue which is consistent with the policy she has been pursuing. I will try to be as helpful as possible in responding to the matter which has received some coverage outside the House in recent times. The general medical services, GMS, scheme, which is more commonly known as the medical card or choice of doctor scheme, was introduced in 1971 to provide general practitioner medical and surgical services to eligible people and replaced the previous dispensary system. Today approximately 30% of the population is covered under the scheme with approximately 1,900 GPs contracted to provide services to people holding medical cards and GP visit cards.

Under the GMS scheme, general practitioners hold one of two contract types — the fee per item contract, which was first introduced in 1972; or the capitation contract, which has been effective since 1989. These contracts reflect the agreed outcome of negotiations between the Department of Health and Children and the GP representative body, the Irish Medical Organisation. Both contract types contain provisions which were agreed between the parties on a range of issues including retirement age. These contract types are contracts for service rather than of employment. GPs who provide services under their GMS agreement to medical card and GP visit card holders, are also entitled to provide services to persons attending their practice in a private capacity.

The terms agreed in the 1972 fee per item contract provide that the contract agreement will cease on the medical practitioner reaching the age of 70 years. The terms of the capitation contract which was agreed between the parties in 1989 provide that GPs who entered into contracts on the date of its commencement could hold the contract up to the age of 70 and that all subsequent GP contractors could hold the contract up to the age of 65. Any changes to these arrangements would require agreement between the parties involved and would need to include consideration of all relevant factors, including the pension arrangements for GMS GPs. General practitioners may, of course, and subject to continued registration with the Medical Council, continue to practise and to treat private patients following retirement from the GMS scheme.

A review of the contractual arrangements for the provision of services under the GMS and other publicly-funded schemes commenced in October 2005 and is being conducted under the auspices of the Labour Relations Commission. I hope this review can be concluded quickly. The Government wishes the new contractual arrangements to provide for open access to public contracts for all qualified GPs meeting particular requirements. I am also open to considering whether it would be appropriate to change the present arrangements regarding the age at which GPs must cease to hold contracts. I have therefore asked the Department, in conjunction with the Health Service Executive, to consider this matter in the context of the joint review process being conducted under the auspices of the Labour Relations Commission.

Mary O'Rourke (Fianna Fail)
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Well done.

Mary White (Fianna Fail)
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I thank the Minister of State and congratulate him on his portfolio with responsibility for the elderly.