One of the country's two GP representative bodies has rejected the deal agreed last week which will provide for free GP care for all under sixes to be introduced this summer.

The National Association of General Practitioners (NAGP), which claims a membership of 1,200 GPs, has rejected the deal, ‘based on the information currently available.'

The proposals were rejected by the NAGP's 23 member council, with the NAGP union claiming that the agreement does not serve the interests of patients or doctors.

The NAGP says the under sixes scheme will result in ‘medical apartheid', as it will provide free GP care for under sixes from relatively well-off families while others on low incomes and with special needs are denied medical cards.

Meanwhile, the largest doctors' union, the IMO, at its AGM in Kilkenny at the weekend, discussed the new under sixes deal it recently agreed with the Government.

Speaking to the meeting, incoming IMO President Dr Ray Walley described the new agreement as a 'first step on the road back to a sustainable and viable general practice system'.

He stressed that the deal would see additional investment of over €75 million in general practice through the under sixes contract and the special GP care programme for patients with Type II diabetes.

Under the new agreement, GPs will receive a yearly fee of €125 per child under six - an increase of 82% on the current rate, according to the IMO. Including additional payments and supports, the total payment to GPs per patient under six in future will be €216.

The agreement also includes provisions for additional payments for patients over the age of 2 with Asthma and payments for GPs undertaking a "cycle of care" programme with patients with Type II Diabetes.

The latter programme is designed to encourage an increasing number GPs to treat patients with diabetes on a regular basis and thereby make these patients less reliant on overstretched hospital services.

While many GPs at the AGM welcomed the new agreement, there were concerns expressed about its workload implications and concerns about the damage caused to general practice through years of under-resourcing and fee cuts.

While at this stage it is expected that a majority of GPs will take part in the under sixes scheme, there are fears that a significant minority will opt out, meaning that parents of children under six would not be able to avail of the free care scheme with their current GP.

In these circumstances, patents, either private patients or medical card holders, would have the option to move their children and themselves to other practices, where feasible.

In these circumstances, GPs who opt out of the under sixes scheme would stand to lose significant income.

Free GP care for under sixes finally agreed