The Government has reached agreement with the doctors' union, the IMO, which will allow for the introduction shortly of free GP care for all under sixes in the population. GPs will receive a basic fee of €125 per annum for treating patients under the age of six.

The two sides have agreed on a contract for the provision of GP services to all under sixes, which includes expanded services for children under six with asthma. It is expected that free GP visits for all under sixes will be introduced during the summer.

The agreement also provides for a special GP care programme for diabetes patients who have medical card or doctor visit cards.

Under the agreement, the Government has pledged to increase its investment in providing GP services to children under the age of six to €67 million - an 81% increase on the €37 million originally identified by Government, according to the IMO.

The agreement provides for GPs to be paid €125 per child patients under six - 82% up from the €68.65 currently received for under sixes who hold medical cards. The IMO says that including additional payments and supports, the total payment per patient under six in future will be €216.

Currently, children under six with medical cards received both free GP visits and are also covered for drug costs with the exception of a prescription charge of €1.50 per item. The new scheme will provide for free GP visits only for all under sixes who currently do not hold medical cards.

Additional fees for GPs have also been agreed for treating children under six who have asthma and certain items of service have been excluded from the agreed yearly treatment fee for under sixes.

Under the agreement, GPs will also receive special payments for treating diabetes patients. GPs will in future receive separate payments of over €100 per diabetes patient per year.

This is regarded as an important development. GPs have for many years protested that while while many of their number provide ongoing treatment for diabetes patients, general practice has never been specifically incentivised or resourced to provide this service in a structured way.

The recognition of the GP's role in the treatment of asthma and diabetes patients under the agreement is regarded as an important step in incentivising GPs to keep patients out of hospital by taking on more chronic disease care in the community.

Welcoming the agreement, IMO GP leader Dr Ray Walley said it was a significant first step in a process to get additional funds into general practice to enable it to deliver on its potential to provide a service to patients that is sustainable, viable and deliverable.

"We have stopped the cycle of cutbacks and begun the process of bringing new resources into general practice. We have more to achieve but we are committed to the development of a new GP contract that is capable of delivering 21st century GP care to patients."

Free GP care for children under six, which has been promised for the past four years, is expected to be introduced in the coming weeks following the agreement. It is also plamned to introduce free GP care for all over 70s shortly and eventually, free GP care for the entire population.

However, a major expansion of free GP care will have to be further negotiated between the Government and IMO.

The IMO said it will be a matter for individual GPs whether to accept the terms offered in the under sixes contract. Not every GP may agree to take part in the under sixes scheme, and a rival GP organisation, the NAGP, has advised its members not to sign up for it.

Plans for the expansion of free GP care had previously been delayed by contractual issues and legal disputes over GP negotiating rights between the Government and the IMO.

Relations between GPs and the Government have also been strained in recent years by substantial cuts made in doctors' payments for work done on State schemes.

The GP agreement announced today also provides for a dispute resolution procedure that will apply across the medical card and under sixes contracts and provides for GPs to continue working in the medical card scheme up to the age of 72 if they wish.

The agreement also provides for flexible or shared working arrangements for GPs who wish to share a wholetime practice commitment.

Health Minister Leo Varadkar and junior health minister Kathleen Lynch welcomed the agrement.

"This agreement represents the first step in the phased introduction of a universal GP service without fees," Minister Lynch said. "The commencement of this service this summer will make a real difference to the lives of the youngest in our society."

Mr Varadkar said the deal was "a major step forward in improving access, quality and affordability of health care in Ireland".

"I want to thank the IMO for their leadership in coming to this agreement and I firmly hope all GPs sign up to this new improved and expanded primary care service."

A special national GP meeting will be held at the IMO AGM on Saturday to discuss the new agreement.