Dear Colleague,

As you are aware, the Department of Health is continuing with plans to drive through free GP care for under-6’s while ignoring the very real concerns and views of GPs. Talks are continuing between the Department of Health and the IMO in the erroneous belief that GPs will mutely accept whatever contract is thrust upon them, while the profession’s repeated calls for a more comprehensive and equitable investment in general practice are summarily ignored.

Consequently, the NAGP is hereby advising all member and non-member GPs to collectively refuse to sign this new contract, regardless of the remuneration it offers.

The NAGP has found itself with no alternative but to adopt such a stance based on the following:

1. Ethical obligations

Section 49.1 of the Medical Council Ethical Guidelines states:

“Subject to your duty to act in the best interests of patients, you have a responsibility to engage and advocate with the relevant authorities to promote the provision of appropriate healthcare resources and facilities.”

Section 49.2 states:

“You have a duty to assist in the efficient and effective use of healthcare resources and to give advice on their appropriate allocation.”

The use of scarce resources to fund this scheme is morally and ethically abhorrent. It is the NAGP’s view that we have an ethical responsibility to resist the introduction of an economically irresponsible measure which will see scarce public funding directed towards a well portion of society while more vulnerable patients are excluded.

2. Ongoing underfunding of general practice

Since the financial emergency of 2009, the amount of resources allocated to general practice has been reduced by 40% – the biggest single cut to any sector of the public service. While cuts to other parts of the health sector have, to some extent, been restored, this has not happened to general practice. In addition to this resource reduction, GPs have taken on an additional 1,000,000 medical card holders since 2008. General practice in Ireland no longer has the manpower or capacity to undertake any further obligations.

3. Morale and wellbeing

A recent NAGP workload and mental health survey indicated that practices are already operating at beyond maximum capacity. Approximately 80% of practising GPs are reporting adverse effects to their health trying to deal with the level of demand placed upon them already. They are, in short, exhausted. The Government must prioritise a programme of support for general practice in the main in order to restore GPs’ battered morale and stop the haemorrhage of newly trained GPs who are leaving our country.


We will continue to petition the Minister for full and meaningful representation in any and all discussions regarding the development of general practice. We will persist with our efforts to have the views of NAGP members and general practice as a whole recognised and addressed.

It is the view of NAGP that the Minister should suspend the misguided, inequitable and unworkable under-6’s scheme and to instead, establish an independent cross-sectoral body on health reform, with the real intention of renewing, invigorating and strengthening general practice and primary care so that it may meet the challenges and opportunities that are emerging daily. We urge him to engage with the NAGP and refrain from his current path of confrontation.

Until the issues are addressed, we urge our members and all GPs to collectively reject any future under-6 contract as a divisive distraction from the real job of repair that needs to begin now.

In order to get an accurate opinion from GPs surrounding the under sixes and other issues a survey will be sent to you tomorrow morning. Please take the time to respond. This will help us in our efforts to campaign on your behalf.

Thank you and regards,

Dr Andy Jordan
NAGP Chair

Dr Conor McGee
NAGP President