Dominic Hannigan (Meath East, Labour)

I welcome the opportunity to speak on the Bill and I strongly welcome the changes that will be brought in by its introduction. The introduction of competition into the GP market will see a reduction in prices for patients, which is a good thing for the two out of three people who need a GP but do not have access to a medical card. It will mean that GMS patients will not have to wait as long to be seen by the local doctor as more doctors will be available. It will also see a reduction in the numbers attending hospitals as illnesses are caught more quickly and people get to the doctor in time. It will also mean that new GPs who are finishing their training will have greater opportunities in Ireland, so many of them will not have to go abroad to work in places such as Australia or the UK but can practice at home.

We need to be very clear about this. The Government's priority is to make sure every euro spent in our economy is spent effectively. The current GMS contract has not seen a good return on investment for the general public because of the restricted access to the scheme. We have fewer than one GP for every 1,000 people, which compares to the figures in the United States and Germany. According to the Competition Authority, my county of Meath has the least number of GPs per head of population, which is not good enough.

I see this Bill as bringing more responsibility to the public funding of GPs. At present, we are spending just over €400 million a year to fund GP visits alone, and this is spread among approximately 2,300 GPs. At a time when everybody is being asked to tighten their belts because of the state of the economy, the average payment to GPs is some €220,000 a year, which includes funding to run their surgeries. However, that is not ring-fenced just to be spent on public patients so the general public through taxation is subsidising the operation of GP surgeries for both public and private patients. Moreover, that payment of €220,000 is just an average. Some GP practices are getting a lot more than that, depending on the number of public patients they see. Of course, GPs are not only seeing public patients but are seeing private patients as well, so the other 50% of visitations are from private patients who are paying between €50 and €70 per consultation. The price for a consultation has not gone down to reflect the pressure on people's pockets over the past three years. In fact, the cost of going to the doctor has risen by nearly 90% since 2000, whereas inflation was just 30% over the ten years since then.

Another issue is that many surgeries, some 50%, do not display their prices, so it is very difficult for people to work out whether one doctor's surgery is giving better value for money than another. In addition, some GPs are asking patients to pay for services that are covered by the GMS, an issue I have raised in the House previously. People in Meath who have medical cards have told me that doctors asked them to pay for blood tests. It is an issue I will continue to raise as these are vulnerable people who are too scared to speak back to the doctors and to complain, and they end up paying for a service that the Government is paying for through the GMS system. The IMO claimed that GPs were giving people free blood tests and that the Government is at fault due to tightening its budgets but this is hardly fair at a time when we are giving the average practice €220,000 per annum. I call on the Minister to ensure no patient under the GMS receives less treatment than it is contractually bound to under the scheme between GP and patient.

I support the Bill and am glad to see it introduced. I wish the Minister the very best in this reform of the health service.

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