Hundreds of GPs are emigrating, some are foregoing their wages to try to keep their practices running and many practices may have to close down a result of cuts to fees and resources and poor working conditions for family doctors, it has been claimed.

East coast GPs, at major meeting held in Dublin last night, strongly criticised the Government over its policy on general practice, particularly over its GP fee cuts, and plans for the under sixes free GP care scheme and the draft contract to operate it, which they claim is unworkable.

Dr Ray Walley, GP Chairman of the IMO, speaking before the meeting, criticised the Government's interpretation of the Competition Act, backed by the Competition Authority, which it claimed stipulated that GPs cannot collectively negotiate fees.

The Government has said while GPs can make submissions on fees, they cannot directly negotiate on this issue and only it can ultimately set the fees.

Dr Walley said said the Government could directly negotiate fees with the IMO if it wanted to, and pointed out that a former Attorney General, Paul Gallagher SC, had already said the Competition Authority's position on GP fee negotiations was wrong.

The issue of GP negotiating rights is to be decided on in the High Court next month. Dr Walley said the issue was not simply about fees paid to GPs, but about the proper resourcing of general practice.

The IMO says it has written to Minister for Primary Care Alex White calling on him to begin comprehensive negotiations and has invited him to attend a GP meeting at its AGM later this month to debate the issues.

Speaking before last night's meeting, Dr Stephen Murphy, Chair of the east coast section of the National Association of GPs (NAGP), said GP fees for treating medical card patients had been cut by 38% in recent years.

He said as a result of Government policy, general practice as we know it would start to become deconstructed, and some practices were insolvent.

Dr Aifric Boylan, a young GP currently working in Enfield, Co.Meath, said she was planning to emigrate to Australia.

She said that up to a year ago she had felt optimistic about the future, but had since grown to realise that the business of general practice had become unviable.

"As things stand, I can't imagine opening a practice myself or taking over a practice. It would lead to my financial demise."

She said she knows of GPs who have not recently taken their wages from their practice income, as otherwise they felt their practices would go under.

Kieran Ryan, Chief Executive of the Irish College of GPs, said the results of a recent survey it carried out among trainee GPs showed that up to nearly 50% of them were seriously considering emigration, whereas the proportion planning to emigrate would would previously have been around 10% to 12%.

He said the main reasons they gave for wanting to leave was lack of stability in Irish general practice and their perception that with all the planned changes, lack of engagement from the Government about them, and lack of clarity about resources and funding, they did not feel the job they were training for was viable.

Mr Ryan said it was not just about the prospect of higher earnings abroad. GPs mainly wanted a stable environment in which they could practice to the high standards they are trained to.

Dr Walley said it was not simply a question of the Government agreeing to pay GPs higher fees, but of it resourcing general practice properly.

He said for the first time ever, middle-aged GPs were also emigrating from Ireland because of the current state of general practice here.

In north Dublin, there had been three medical card lists with 1,100 patients ‘handed back' to the HSE, and this was happening throughout the country.

Dr Walley said the talks being proposed by the Government with GPs were not real. "Effectively we would be agreeing to services without knowing the resource or fees attached to them," which would be dictated by the Government.

He said the draft contract allowed the Government to dictate workload and resources for GPs, and there were capacity issues with the workload envisaged in the new contract. There were also issues in the contract relating to areas such as immunisations and data protection.

Asked of the Government made a fees offer to GPs without negotiations and a large number of GPs took up the contract despite the concerns expressed about it, Dr Walley said the IMO was not advocating that GPs should not sign up in such circumstances.

"We are asserting our right under competition law to negotiate. GPs are entitled to sign on - it will be an opt-in system. We as a union are entitled to advise GPs as to the implications of any proposed contract."

Dr Boylan said as a result of the current resource situation in general practice, some GPs were not drawing salaries, were not able to fix broken equipment in their surgeries and could not afford to hire locum replacements to take holidays.

She said many practices, especially in more deprived areas, which have high numbers of medical card patients, were now insolvent.

Dr Boylan claimed a major factor in low morale among young GPs was the constant portrayal of them as high earners, when this was not the case.

Chris Goodey, CEO of the NAGP, said he had been informed yesterday by a GP in Waterford that after seven years of practice he had just ‘closed his doors'. He felt many more GP practices could follow suit.

Greystones, Co Wicklow GP Ciara Kelly said many GPs were now considering their options. One GP had informed her that he had not drawn a wage between June and October of last year.

She said her own income was currently down by 46%.

"Perhaps the perception is that we were too well-paid in ther past. But the reality is we are small/medium enterprise (SME) owners, and it is incredibly difficult to run a business."

Dr Kelly said for the first time, her mortgage had fallen into arrears last year, despite her being what might be considered a successful GP in a leafy suburb of Dublin.