Free GP care for all children under 12 is to be phased in over three years following a €210m deal with family doctors.

The plan - to be announced by Health Minister Simon Harris - is to introduce free visits for under-eights in July next year, under-10s in 2021 and under-12s in 2022.

The rollout of free GP care to older children - already available for under-sixes - has been agreed "in principle" by the doctors' union, the Irish Medical Organisation (IMO), in marathon negotiations.

It lifted its opposition to the long-running proposal, which was originally promised by Taoiseach Leo Varadkar in 2016.

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Speaking about the plan this morning, Mr Vardkar said that he is delighted to finally agree on a contract after long negotiations.

"I am very happy that we have been able to conclude an agreement with the IMO on a revised GP contract,” he said.

“The Minister for Health and I are also signalling our intention to extend the free GP care scheme for children which currently applies to children aged five and under, to all children aged 6-12.

“Alongside the new staff nurses contract agreed with unions earlier this week and the reduction in prescription charges and the widening of income limits for the GP Visit Card, I believe this represents a major step forward in the implementation of Slaintecare, increased resourcing of primary care.”

But widening the free scheme to more than 200,000 extra children will still have to be subject to a new round of talks to work out a fee for GPs - and it is up to individual doctors to decide whether they want to sign up.

The breakthrough came during marathon talks on a €210m investment package for general practice.

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Key to the agreement is the gradual reversal over 30 months of the cuts imposed during the recession to GP fees for treating medical card holders and other State services.

Many doctors said these crippled their practices at a time of increasing workload, forcing growing numbers to stop accepting new patients.

The GPs will get around €25m repaid in July 2019, and another €35m is due from January 2020.

Full restoration of the remaining €60m in monthly payments will start from January 2022.

The deal will also result in more medical card patients with long-term conditions such as diabetes, cardiovascular disease and pulmonary illnesses being treated by their GP instead of a hospital clinic.

This €80m investment in care of patients with a long-term disease will be phased in from January next year, covering 400,000 people.

It also includes provision for annual check-ups for high-risk patients - who have blood pressure issues or are pre-diabetic.

All the extra workload is on an opt-in basis and it will be a matter for individual GPs to agree to sign up.

The deal was negotiated between the Department of Health and the IMO.

"This is an important step towards investing in general practice and valuing it as a vital part of the health service," said IMO GP spokesperson Dr Padraig McGarry.

The IMO will now organise a series of consultative meetings for members and a ballot of GP members on the deal.

"This is not an increase in pay for GPs - this is a restoration of fees for services to patients. GP services suffered badly during the austerity years and were left behind as other sectors saw their cuts restored."

He said that as part of the productivity arrangements for the restoration of fees, GPs would co-operate with health service reform through involvement in the rollout of community healthcare organisations. This aims to deliver targeted services to patients outside hospital.

"Additionally, GPs will co-operate with e-health initiatives such as e-referrals and e-­prescribing and an integrated patient summary record which should lead to greater efficiencies in general practice and support patient care.

"An important medicine safety initiative is also part of the agreement whereby GPs will receive support and advice from HSE pharmacists for patients over 75 who are on multiple medications."

Referring to plans to extend free visits to under-12s, he admitted there were "issues that remain to be negotiated".

"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."

It comes against a background that several areas of the country are facing a GP crisis.

Around 700 GPs are due to retire in the next three to five years and many trainees are emigrating. There are only around 90 GPs under the age of 35 providing services to medical card patients.

Some areas of the country cannot attract a doctor to take over a general practice.

Under the new deal, GPs who are on maternity leave will get a higher payment to pay a locum to take their place.

There is also provision for male doctors to take paternity leave for up to 14 days, compared to the current three days.

They will get a payment from the HSE to hire a locum to take their place during that time.

This is seen as an incentive to make general practice more family friendly and keep young doctors in Ireland.

Irish Independent