GP National Meeting Motions    Saturday 2^nd April 9am – 12.30pm

NEW GP CONTRACT

1. This meeting calls on the incoming Government to prioritise resources for a new GP Contract that is capable of delivering a modern GP service to GMS patients, particularly in light of the fact that the current contract does not allow for the provision of adequate services. 

Proposer: IMO GP Committee

Status: Carried

2. That prior to any further nationalisation of General Practice the IMO engage in an active process with its GP members to ascertain that this is what they want.

Proposer: Dr H Finnegan

Seconder: Dr D Dolan

Status: Carried

3. That the IMO conduct a needs analysis with younger GPs in terms of the development of General Practice to ensure that any contract is fit for purpose to meet their needs now and into the future.

Proposer: Dr H Finnegan

Seconder: Dr D Dolan

Status: Carried

4. That the IMO should send a detailed questionnaire to all GPs with GMS numbers to try and discover the worries and actual current state of affairs.

Proposer: Limerick GP Branch

Status: Carried

CHRONIC DISEASE PROGRAMMES

5. This meeting calls on the Minister for Health and the HSE to commence negotiations on Chronic Disease Management in General Practice.  All medical evidence clearly supports such investment as being better for the patient in terms of health outcomes and delivering better value to the State with clear economic benefits.

Proposer: GP Committee

Status: Carried

6. That the IMO negotiate that no more than 6 KPIs be included in any returns on any one Chronic Disease Management programme between the HSE and GPs.  Further that the IMO agrees CDM can be done in General Practice provided the OPD budget in secondary care is transferred in full to general practice.  The IMO may negotiate a discount on that budget.  The IMO agrees Chronic Disease Management cannot be provided under the current GMS capitation system.

     Proposer: Dr H Finnegan

     Seconder: Dr D Dolan

     Status: Amended and Referred to Committee

6. That the IMO negotiate that no more than 6 clinical data inputs be included in any returns on any one Chronic Disease Management programme between the HSE and GPs.  Further that the IMO agrees CDM can be done in General Practice provided the OPD budget in secondary care is transferred in full to general practice.  The IMO may negotiate a discount on that budget.  The IMO agrees Chronic Disease Management cannot be provided under the current GMS capitation system.

7. This meeting calls on the Departments of Finance, Public Expenditure and Reform and the Department of Health to commit to ring fenced incremental funding for Chronic Disease Care Programmes.

Proposer: IMO Clare GP Branch and IMO GP Committee

Status: Carried

SPECIAL ITEMS OF SERVICE

8. This meeting calls on the HSE/Department of Health to commence negotiations with the IMO in the context of a new GP Contract and under the Memorandum of Understanding on a modern Special Items of Service list which reflects the full economic cost of providing the service.

Proposer: Dr H Finnegan

Seconder: Dr D Dolan

Status: Carried

 

OUT OF HOURS

9. That the IMO agrees the contractual obligation on GPs to provide Out of Hours Cover for GMS patients is unsafe for doctors and patients and should cease in the interest of patient safety.

Proposer: Dr H Finnegan

Seconder: Dr D Dolan

Status: Referred to GP Committee

10. This meeting calls on the HSE to negotiate a separate contract for the provision of Red Eye Out of Hours Cover and that GPs may have the option of taking up the contract or to opt out from 24 hour responsibility.

Proposer: IMO Mayo GP Branch

Status: Referred to GP Committee

INFRASTRUCTURE

11. This meeting calls on the Department of Health and the HSE to recognise the significant investment by General Practitioners in the development of primary care facilities and to negotiate a range of measures to support the ongoing costs of maintaining such facilities.

Proposer: IMO GP Committee

Status: Carried

12. This meeting calls on the Departments of Health, Finance and Public Expenditure and Reform to note the IMO submission to the Indecon Report and to implement appropriate measures to encourage GPs to develop primary care facilities and importantly to allow GPs who have already invested significantly in such facilities to avail of the appropriate measures which should include tax relief and infrastructural grants.

Proposer: IMO GP Committee and IMO Mayo GP Branch

Status: Carried

13. That the burden of bureaucracy in general practice in relation to social care must be reduced and we call on the HSE and Department of Health to adequately fund IT supports so that the administrative burden may be reduced.

Proposer: Dr H Finnegan

Seconder: Dr D Dolan

Status: Carried

LOCUM ISSUES

14. This meeting calls on the Department of Health and HSE to recognise the cost of locum provision and seeks a contribution of €120 per hour to cover attendance at Primary Care Meetings.

Proposer: Mayo GP Branch

Status: Carried as Amended

This meeting calls on the Department of Health and HSE to recognise and to provide adequate resource to cover the cost of attendance and follow up care arising from attendance at Primary Care Meetings.

15. That the IMO demand a return to the provision of full €400 per day sick leave locum fee contribution for a total of 6 months instead of the current 3 months as many GPs are struggling to keep practices going while employing a locum to cover them during prolonged sick leave.

Proposer: Mayo GP Branch

Status: Carried as Amended

15. That the IMO demand provision of full sick leave locum fee contribution by the HSE as many GPs are struggling to keep practices going while employing a locum to cover them during prolonged sick leave.

16. This meeting considers that it should be the responsibility of the HSE to find a locum in the unfortunate event of a GP becoming acutely ill and necessitating hospitalisation, particularly in rural areas.

Proposer: Mayo GP Branch

Status: Carried as Amended

16. This meeting agrees that it be the responsibility of the HSE to find a locum in the unfortunate event of a GP becoming acutely ill and necessitating hospitalisation, particularly in rural areas.

PRACTICE SUPPORTS

17. This meeting calls on the HSE and Department of Health to allocate full practice support allowances to panels from 700 upwards so that a practice nurse and secretary can be employed.

Proposer: Mayo GP Branch

Status: Carried as Amended

17. This meeting calls on the HSE and Department of Health to allocate full practice support allowances to panels of 700 and pro rata upwards so that practice nurses, secretaries and a practice manager can be employed.

PCRS

18. This meeting calls on the PCRS to ensure capitation payments for a newly registered patient or re-instated patient are paid for the full month in which they are registered or reinstated.  Furthermore when a patient is allocated or transferred to another practice that capitation payment continues to the existing practice for the month in which the transfer occurred.

Proposer: IMO Clare GP Branch

Status: Carried

FEMPI

19. This meeting calls on the Minister for Health and the Minister for Public Expenditure and Reform to immediately commit to the unwinding of FEMPI cuts in line with the arrangements prevailing in the public service for the unwinding of such cuts and further that it be recognised the significant difference in the level of cuts imposed to General Practice vis a vis other groups and that the unwinding must take account of this.

Proposer: IMO GP Committee, Mayo GP Branch, Dr H Finnegan, Dr D Dolan

Status: Carried

20. This meeting calls on the Department of Health and the HSE to reinstate Distance Coding.

Proposer:  IMO Mayo GP Branch, Dr H Finnegan, Dr D Dolan

Status: Carried

21. That the IMO seek the reversal of FEMPI cuts and Distance Code cuts prior to any further IMO/HSE General Practice Agreements.

Proposer: Limerick GP Branch

Status: Carried as Amended

21. That the IMO seek the reversal of FEMPI cuts and Distance Code cuts.

Pensions

22. This meeting calls on the Department of Health and the HSE to recognise the inequity of the GMS Pension Scheme as compared to other health grades within the public health services and further note that this is an obstacle to retaining or attracting GPs in Ireland.  The IMO calls for negotiations on improving the GMS pension arrangements so that GPs can be guaranteed an appropriate pension upon retirement.

Proposer: Dr Tadhg Crowley

Seconder: Dr Bill Cuddihy

Status: Carried

23. This meeting calls on the Trustees of the GMS Pension Scheme to appoint a corporate trustee.  Such Trustee to be fully independent of and have no financial relationship with the fund administrators or any subsidiary of the fund administrators, or any links to the investment or actuarial advisors to the Scheme.

Proposer: Dr Frank Clarke

Seconder: Dr Sarah Hooper

Status: Carried

 

PRIVATE HEALTH INSURANCE COMPANIES

24. This meeting calls on all providers of Private Health Insurance to ensure they have representation from General Practice on their boards.

Proposer: IMO Mayo GP Branch

Status: Carried

25. This meeting calls on all Private Medical Insurance providers to review the fees paid to GPs for procedures to take account of the true economic cost of providing this service to the medical insurance provider clients.

Proposer: Dr H Finnegan

Seconder: Dr D Dolan

Status: Carried

WORKLOAD

26. The IMO agrees the burden of work being transferred from hospital medicine to general practice is excessive and needs to be rationalised.

Proposer: Dr H Finnegan

Seconder: Dr D Dolan

Status: Carried

 

PRESCRIBING

27. That the IMO would seek the reinstatement of indicative drug budgeting which could yield savings for investment in practice development and reduce escalating costs of drugs to the exchequer.

Proposer: Mayo GP Branch

Status: Carried

28. This meeting calls on the Department of Health and HSE to abolish the requirement to hand write prescriptions for Controlled Drugs.

Proposer: Mayo GP Branch

Status: Carried

29. This meeting calls on the Department of Health to allow GPs to directly prescribe Roaccutane

Proposer: Mayo GP Branch

Status: Carried as Amended

29. This meeting calls on the Department of Health to recognise the role of GPs directly prescribing Roaccutane.

30. That the IMO ensure with the relevant authorities that it should be sufficient that one GP signature per page satisfy legal and ethical requirements in prescribing for patients in Nursing Homes.

Proposer: Dr H Finnegan

Seconder: Dr D Dolan

Status: Carried as Amended

30. That the IMO should issue specific guidance to members with regard to prescribing for patients in Nursing Homes.

NEW REGULATIONS FOR GENERAL PRACTICE

31. This meeting calls on the Department of Health and the HSE to negotiate with the IMO in relation to the funding and resourcing required for any new regulations applicable to general practice.

Proposer: Limerick GP Branch

Status: Carried

CME and STUDY LEAVE

32. This meeting calls on the HSE to negotiate with the IMO sufficient funding for the maintenance and development of the GP CME SGL network.

Proposer: Dr H Finnegan              

Seconder: Dr D Dolan

Status: Carried

33. This meeting calls on the PCRS to support a streamlined approach to the payment of study leave (in respect of maintaining professional competence) as the present system adds an unnecessary administrative burden and costs to both the GP and the PCRS.  Given that CPD audits are documented and available for checking by the PCRS the IMO calls on PCRS to agree that once the GP declares completion of the CPD activity the study leave entitlements under the GMS Contract will be paid.

Proposer: Dr Brian O’Doherty    

Seconder: Dr Padraig McGarry 

Status: Carried

TUSLA

34. This meeting reiterates the position that the provision of reports for TUSLA is not covered under the provisions of the GMS contract or the Under 6 Contract and calls on TUSLA and the Department of Children and Youth Affairs to immediately enter into a Framework Agreement with the IMO to negotiate resources for the provision of reports and other related work.

Proposer: IMO GP Committee

Status: Carried

DEPARTMENT OF SOCIAL PROTECTION

35. This meeting calls on the Department of Social Welfare and the IMO to enter into a Framework Agreement so as to allow negotiations to take place on the increasing level of un-resourced work, including letters written by GPs for the Department of Social Protection, which is placing an onerous financial burden on General Practice.

Proposer: Dr H Finnegan

Seconder: Dr D Dolan

Status: Carried

CONTINUITY OF CARE

36. International evidence has clearly demonstrated the importance of continuity of care with a specific General Practitioner along with the clear benefits in terms of patient morbidity and mortality.  The IMO opposes any transfer of care or the introduction of future care models that disrupts this continuity of care and calls on the HSE and the Department of Health to ensure that any proposed task transfer of care from GP led teams be subject to stress testing on the long term effects on patient morbidity and mortality.

Proposer: Dr R Walley

Seconder: Dr T Crowley

Status: Referred to Council

 

ROLE OF THE GP

37. This meeting wishes to express concern about any attempt to expand the role of pharmacists into areas which are more appropriately the responsibility of General Practitioners to ensure continuity of care for patients.

Proposer: Mayo GP Branch

Status: Carried

RECOGNITION OF GENERAL PRACTICE AS A SPECIALTY

38. This meeting calls on the IMO to engage with all relevant authorities to ensure General Practice is recognised as a Specialty by the European Commission by changing the name of GP training in Ireland from “Specific Training in General Practice” to “Specialist Training in General Practice”.

Proposer: Dr H Finnegan

Seconder: Dr D Dolan

Status: Carried