Statement by Irish Medical Organisation (IMO)

 

• Following  months of negotiations, the IMO announces details of €210 million investment secured from Government for General Practice

 

• Deal will see the  long-sought reversal of the controversial FEMPI cuts of €120 million (plus €10 m in pension contributions)  imposed on General Practice at  the height of the financial crisis

 

• An additional fund of €80 million has been secured for the management of GMS Patients with Chronic Disease in the community

 

• Chair of IMO GP Committee, Dr. Padraig McGarry, welcome this significant funding and calls for ongoing investment for the development of General Practice.

Friday 5^th  April 2019.  The Irish Medical Organisation (IMO) has announced details of a negotiated agreement with Government which secures €210 million in increased funding for General Practice over the coming years.  Dr. Padraig McGarry, Chair of the IMO GP Committee, said that the agreement will secure the reversal of the controversial FEMPI cuts which were imposed on General Practice at the height of the financial crisis and which have been a major source of anger amongst GPs.  Government has resisted all demands to reverse  these cuts until  now -  despite reversals happening in the wider public service. 

Dr McGarry said “This is an important step towards investing in General Practice and valuing it as a vital part of the health service.  It will do two things; restore the draconian cuts imposed on GPs and bring new and much needed funding to deliver new services to patients in the community”

The IMO will now organise a series of consultative meetings for members and a ballot of GP members on the deal.

Under the agreement GPs will receive their restoration of FEMPI in four stages.  The first increase will become effective on 1^st July 2019 with phased increases on 1^st January 2020, 2021 and 2022.  

Dr McGarry said “This is not an increase in pay for GPs this is a restoration of fees for services to patients.  GP services suffered badly during the austerity years and were left behind as other sectors saw their FEMPI cuts restored.  As part of the productivity arrangements for the restoration of fees GPs will cooperate with health service reform through involvement in the rollout of Community Healthcare Organisations which aspire to delivering targeted services to patients in the community.  Additionally GPs will cooperate with e-health initiatives such as e-referrals and e-prescribing and an integrated patient summary record which should lead to greater efficiencies in general practice and support patient care.  An important medicine safety initiative is also part of the Agreement whereby GPs will receive support and advice from HSE Pharmacists for patients over 75 who are on multiple medications.  Dr McGarry said “These initiatives represent best practice in medicine and are progressive measures.”  

The Agreement will also see a further €80m invested in General Practice to provide new services for Chronic Disease Management for GMS patients.  This scheme will be in place from January 2020.

Dr. McGarry said that the agreement came after a year of negotiations in 2017 and a further recent six months intensive negotiations and a long running social media and lobbying campaign (#ReverseFempi).

Dr. McGarry also acknowledged  that there are issues that remain to be negotiated  - in particular the extension of Free GP Care for Children up to age of 12.  Dr. McGarry said; “as health professionals we would prefer to see a different roadmap for the expansion of GP Care but we accept that this is Government policy and as part of this Agreement the IMO has committed to entering into a new strand of negotiations on the resourcing and contractual provisions to deliver this service.  It is important to note that both the Chronic Disease Contract and the Under 12 Contract are opt in and this Agreement does not commit individual GPs to the provision of these services.”

Dr. McGarry said that a critical factor for GPs was that the necessity to reverse FEMPI cuts; “we faced a lot of pressure to just ignore the FEMPI issue and focus instead on negotiating a new contract.  However, our members have suffered enormously through the FEMPI cuts and it was critically important to us that we kept the issue of FEMPI separate from the issue of a new contract.”

Dr.  McGarry said that the agreement represented a significant success for General Practice. He said: “The FEMPI cuts have had a disastrous impact on General Practice across the country.  Today we can finally say that we  have agreed a mechanism to reverse those cuts and to restore much needed resources to General Practice.  Our fight for even more investment and a new GP contract does not end today but we do mark a milestone.  Now with this painful issue dealt with, we will move on to discuss further investment and a new contract to underpin General Practice for the next 30 years.  We hope that this investment by Government is the beginning of recognising the value and potential of General Practice and that we can move on to address the issues not included in this Agreement including Women’s Health Programmes, Out of Hours Services and Services to patients in Nursing Homes.”

There are a number of elements to the agreement which the IMO has reached with the Government.

Capitation Fees (monthly fees paid to each GP for each of their GMS Patients)	July 2019	20% increase
	January 2020	2.8% increase
	January 2021	10.2% increase
	January 2022	9.25% increase
Deprived Communities	€2  million per annum investment to support GP practices in areas of high deprivation
Chronic Disease Management [Qualifying Chronic Diseases – COPD, Diabetes, Cardiovascular Disease]	€80 million to support the phased introduction of Chronic Disease Management for GMS patients	Phased introduction starting January 2020 and by 2024 over 400,000 GMS/DVC patients will be in a Chronic Disease Programme or a High Risk Evaluation Scheme
Maternity / Paternity Payments for GPs	Maternity Leave   Contribution to Locum Costs for GPs to increase to €2,760 per week (from €1,300 per week) to fund locums to stand-in for GPs on Maternity Leave from January 2020	Paternity Leave     Contribution to Locum Costs to be available for up to 14 days (currently 3) at the same rate as maternity benefit from January 2020