The debate/ argument/ disagreement about introduction of free GP care for children of 6 and under is now really heating up. There seem to be a few elements at play, including:
- GP view that this change is being forced upon them
- GP view that the government is taking a very specific interpretation of competition law to prevent GPs coming together to argue their case
- GP view that their’s is the one part of the health care sector which is working effectively and why (on earth) would anyone want to break this first up#
- Government determination to push forward with this as one of the first steps in introduction of UHI (to include Primary Care).
I tend to look at GPs much as I look at myself – running their own consulting businesses – with a combination of smaller customers (individual patients) and larger customers (GMS patients through government). And we share many challenges – be it cash management, winning new business, changing economic circumstances, funding a pension, whatever.
But I just read back through the ‘Future Health’ document published by the Department of Health in November 2012. And it’s there in black and white on page 32: ‘…the removal for fees for GP care…..this reform is required because the body of evidence that user fees are a barrier to accessing care at the primary care level and thereby cause late detection of illness, poorer health outcomes and greater pressures on the acute hospital and long-term care systems.’ And they make it clear that the y intend introducing this on a phased basis.
So, in spite of the fact that many may believe the GP system is serving us well, it is clear from the Department’s point of view that the GP system is part of the problem.
And as I reread the Department’s strategy for health and its intentions re primary care and a much broader and more integrated primary care environment I struggle how to see this can be married with the traditional role of the self employed GP. Yes – many go ahead GPs have come together to form practices which enable them to provide a wider range of solutions and to share/ develop specialties. But the language of the document seems to be very focused on integration of GPs and lots of HSE employed professionals (or perhaps the plan is that more of these professionals would operate outside the HSE?) – this does not seem to be clear in the document).
Universal Health Insurance has a long way to run – seems that the GPs are being thrown into the mixer upfront.