A second GP organisation, the Irish College of General Practitioners (ICGP) has announced that it is withdrawing from a HSE care programme in protest at the latest cuts in GP fees.

This follows the withdrawal of the doctors' union, the IMO from the HSE's primary care teams, community intervention teams and clinical care programmes for the management of chronic disease. The IMO's action is currently the subject of a legal challenge by the Competition Authority.

The ICGP announced today that it was withdrawing from the clinical care programmes, but it said unlike the IMO action, it was not withdrawing from working in primary care teams. However, most GPs would be members of both the IMO and ICGP.

The clinical care programmes were launched by the HSE in 2010, aimed at organising services better to improve access to and streamline the treatment of many conditions such as diabetes, asthma and mental health problems, through the cooperative efforts of hospitals, GPs and community healthcare staff.

Many of the initiatives are planning to transfer a significant proportion of workload from hospitals to GPs and primary care services. However, GP groups say they have not been given the proper resources to provide this care.

GP representatives - called clinical leads - currently working on these clinical programme teams, have now been instructed by their college to withdraw from them, following the recent instruction by the GP union, the IMO, to withdraw cooperation from these teams.

The ICGP's head of communications, Dr Darach O' Ciardha, told irishhealth.com that its decision to withdraw from the care programmes would not affect day to day of patients with conditions such as diabetes and asthma.

He said the College was withdrawing from HSE initiatives planning improvements in the delivery of care under a number of disease headings, but it was not withdrawing from service provision.

The College's GP leads on these programmes had been asked to withdraw and had agreed to do so, Dr O'Ciaradh said.

The College, in statement, said it could no longer tolerate a situation where it was expected to participate in programmes that sought to transfer workload to GPs while at the same time the Government was undermining GPs and stripping them of their resources with what was now a third round of fee cuts.

The Department of Health recently announced GP fee cuts of around 7.5% for some services under State schemes.

The ICGP stressed that GPs have the potential to take hundreds of thousands of patients out of the hospital system, saving significant amounts of money and alleviating pressure on hospitals, but they needed adequate reosurces to do this.

Dr O'Ciaradh said for example, it had been planned to transfer the management of patients with uncomplicated type 2 diabetes from hospital to GPs and primary care, thereby freeing up hospital resources to deal with more complicated cases.

However, this transfer of care would require significant additional resources for GPs, which were not forthcoming, he said.

Dr O'Ciaradh said GP workloads were already severely stretched as they were already taking on a lot of additional work such as management of chronically ill patients, much of which had been formerly done by hospitals. At the same time, he said, GPs' financial resources to provide these services were being cut further.

"GPs are willing and able to take on the burden of managing chronic disease, but we need the resources to do it."

Dr O'Ciaradh said the failure to proplerly resource GPs was a missed opportunity.

"If you transfer hospital workloads to GPs and fund this transfer properly, you will ultimately save money for the healthcare budget, improve care, and allow hospitals to work in a more efficient way."

Dr O'Ciaradh said questions would now inevitably be raised about the future of the HSE's clinical programmes.

The primary care teams, which are different from the clinical programmes, and from which IMO GP members are planning to withdraw, involve community health professionals working together, ideally from the same centres.

However many of these teams have been criticised as 'virtual teams' that are working only in theory and not in practice. In addition, the promised network of new primary care centres, first promised in the Primary Care Strategy 12 years ago, hase been slow to materialise.

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