A Turbulent Week for the Tánaiste

Published on 5 November 2020 at 13:40

On Friday, 5 April 2019, the Agreement was announced by the IMO. The details of it were described in a Press Release.


Village Magazine has published an article in its current edition which is both inaccurate and grossly defamatory. The Tánaiste Varadkar has sought legal advice on the content of the article. The facts are that the 2019 Agreement on GP contractual reforms was negotiated by the Department of Health, the HSE and the Irish Medical Organisation (the “Agreement”). The Agreement was agreed and the essential details of it were publicly announced in 2019.


The IMO Press Release of 5 April 2019 set out extensive detail about the Agreement, which included the following detail: “The Irish Medical Organisation (IMO) has announced details of a negotiated agreement with Government which secures €210 million in increased funding for General Practice”.  


Dr P.McGarry said “This is an important step towards investing in General Practice and valuing it as a vital part of the health service.  It will do two things; restore the draconian cuts imposed on GPs and bring new and much needed funding to deliver new services to patients in the community” .The IMO organised a series of consultative meetings for members and a ballot of GP members on the deal.


Under the agreement GPs received their restoration of FEMPI in four stages. The first increase became effective on 1st July 2019 with phased increases on 1st January 2020, 2021 and 2022. Dr McGarry said in 2019“This is not an increase in pay for GPs this is a restoration of fees for services “.


The Agreement has seen a further €80m invested in General Practice to provide new services for Chronic Disease Management for GMS patients.  This scheme was in place from January 2020. Dr. McGarry said that the agreement came after a year of negotiations in 2017 and further recent six months intensive negotiations and a long running social media and lobbying campaign.


Dr. McGarry also acknowledged that there are issues that remain to be negotiated, in particular the extension of Free GP Care for Children up to age of 12. The highly qualified doctor said; “as health professionals we would prefer to see a different roadmap for the expansion of GP Care but we accept that this is Government policy and as part of this Agreement the IMO has committed to entering into a new strand of negotiations on the resourcing and contractual provisions to deliver this service.”

Dr. McGarry said in 2019 that a critical factor for GPs was that the necessity to reverse FEMPI cuts.


There are a number of elements to the agreement which the IMO has reached with the Government. The 2019 IMO Press Release included a table summarising the main features of the Agreement. The fact that the Agreement had been reached and the nature of that Agreement is not something that was confidential or sensitive after 6 April 2019. On the contrary, this information was also in the public domain. The Taoiseach Martin, in his capacity as Head of Government, was keen that the Agreement would be well received by the General Practitioner community. The General Practitioners are not employees. The General practitioners are self-employed contractors and they had the individual entitlement to accept or reject the new contract.


At this time, Dr. Maitiú Ó Tuathail was the President of the National Association of General Practitioners, an alternative representative organisation of General Practitioners. The then Taoiseach Varadkar did provide a copy of the Agreement to Dr. Ó Tuathail on a date between 11th and 16th April 2019. The Agreement was provided to Dr. Ó Tuathail, as President of the NAGP in circumstances where the Taoiseach believed that the deal was a positive one for General Practitioners that the then Government wished to see implemented. Varadkar hoped to use Dr. Ó Tuathail’s influence to encourage all GPs to accept it including those represented by NAGP.


The Agreement had been negotiated with the IMO, and the publication or circulation of the Agreement to the members of the IMO was within the discretion of the IMO, which had already issued a press release setting out its essential content. The provision of the Agreement to Dr. Ó Tuathail requires to be seen in the context of the potential unfairness of one representative body for General Practitioners having access to the Agreement at a time when the other representative body (the NAGP) did not. The Government had publicly committed to keep the NAGP informed as to the progress of negotiations.  


The provision of a copy of the agreed and publicly announced Agreement by the Taoiseach to the President of the NAGP was honouring a political commitment previously made by the Government.


By definition, given that it had been extensively negotiated between Government and the IMO, many people outside Government in the IMO were already well aware of its content, and the essential details of the Agreement had been described in press releases which were reported upon in the media.


The provision of a copy the Agreement to 31 year old Dr. Ó Tuathail, in his capacity as President of the NAGP occurred in circumstances where the legitimate objective of this action was to encourage acceptance of the Agreement amongst the General Practitioner community. The entire purpose of the then Taoiseach and the Minister for Health issuing a Press Release on 6 April 2019 was to advance precisely the same objective. The current Tánaiste accepts that the provision of the Agreement by an informal communication channel to the President of the NAGP was not best practice and he regrets that he did not ensure that it was provided in a more appropriately formal manner.

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