The head of the Irish College of General Practitioners (ICGP) has stressed that Government resources should not be used to provide universal access to GP care for under sixes at the expense of the elderly, the chronically ill, or those requiring long-term medical treatment and monitoring.

Incoming President Dr Tony Cox told the ICGP AGM in Galway that the recent removal of many discretionary medical cards exposed the failings in Government's proposed reform of the health system and of general practice in particular.

"In a future health system, where patient care is not prioritised, the risks to patient health and well-being, as evidenced by discretionary medical card 'probity', are grave," Dr Cox said.

"There is no third, first or second tier patient in general practice, where all patients are treated equally based on medical need.

Dr Cox said the recent decision to introduce a 'third-tier' medical card was reactive policy making and created a further administrative burden for GPs.

He said the draft legislation on the planned under sixes scheme needed further debate before enactment.

He said the ICGP ,which represents the vast majority of GPs practising in Ireland, could not endorse a universal provision of free GP care for patients where the need is not obvious, 'and particularly, while we see the effect the removal of discretionary medical cards is having'.

On universal health insurance, Dr Cox said the recently published Government White Paper had little clarity in relation to how universal healthcare would operate or on what the impact on patient care would be. 

Dr Cox said the standards which Government should consider in relation to its healthcare reform included that reform should be proportionate and based on medical need.

It should also ensure that ensure patients with greater medical need are not being denied care

Dr Cox also said future reforms should not reduce available GP time for seeing patients.

"Offering care to all under sixes including a wellness check-up places an additional administrative burden on GPs. Government needs to put the necessary IT and practice nurse resources in place to deliver this service effectively."

Meanwhile, tentative signs of progress emerged from a meeting yesterday between the doctors' union, the IMO, and Primary Care Minister Alex White, on 'talks about talks' on implementing the under sixes GP scheme. Both sides described the meeting as useful, and are due to meet again next week.

GPs have objected to a draft contract drawn up by management for the operation of the scheme and they have also clashed with the Government over its insistence that there cannot be direct negotiations on fees.