Surgery poster on medical card services causes GP concern

IMO rejects claim message suggests withdrawal of services from some patients

Dr Paul McKeown, president of the Irish Medical Organisation, which has drawn up a poster outlining services not covered by the medical card. Photograph: Dara Mac Dónaill/The Irish Times
Dr Paul McKeown, president of the Irish Medical Organisation, which has drawn up a poster outlining services not covered by the medical card. Photograph: Dara Mac Dónaill/The Irish Times

A poster sent to GP surgeries nationwide in recent days which outlines services that are not covered by the medical card has met with mixed reaction from doctors.

The poster, drawn up by the Irish Medical Organisation and distributed to GP surgeries, states that, while the medical card entitles holders to a wide range of GP services, a number of additional services provided by many GPs are not included in the agreement between practitioners and the State.

The poster lists a number of these, including routine blood tests, men’s and women’s health clinics, and chronic disease management. It also sets out the average payment to GPs for patients, split into price bands depending on a patient’s age and gender.

Dr Austin O’Carroll, a Dublin-based GP, has described the poster as “a disgrace” adding that displaying such a poster could interfere with the doctor/patient relationship among a “vulnerable group with significant financial problems”.

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He added that inclusion of an average cost per patient of €8.83 was misleading as he said many medical card patients would not visit their doctor every month and “a lot of patients don’t attend in the year”.

Dr Mel Bates, of Fairview Family Practice in Dublin 3, said the poster was "unacceptable and offensive". He feared displaying it could discourage certain medical card holders from going to their GP.

Following demand

However, Dr Ray Walley of the IMO, who runs an inner-city surgery in Dublin, said the organisation provided the posters following demand from GPs who he said are facing ever-increasing pressure for services without the provision of adequate resources.

“In no way does the poster state that people are being advised to withdraw services,” he said.

He added that a covering letter accompanying the poster said GPs “may” choose to display the poster but were under no obligation to do so.

He said the poster was a “proactive education tool”, the aim of which was to clarify what services GPs are and are not contracted to provide. “If it continues like this . . . then we are not going to be able to do our job,” he said.

He pointed out the poster had been agreed upon by 20 IMO members representing 2,000 GPs nationwide – many of whom had requested that such a poster be drawn up.

Dr Walley said that nowadays GPs are essentially small and medium-sized enterprises which have faced rising energy costs, rates and other costs in recent years: “Some GPs are on a financial precipice.”