Tony McLoughlin (Sligo-North Leitrim, Fine Gael)

I welcome the opportunity to speak on the Bill, which in effect will allow qualified general practitioners to treat public patients as part of the GMS. The restrictive practice of this area was identified by the IMF-EU agreement with Ireland, to increase competition among sheltered professions by the third quarter in 2011. A number of provisions in the Bill will benefit the State, the patient and ultimately ensure the sector is more competitive.

The HSE can enter into a contract for the provision of services to GMS patients with any suitably qualified and vocationally trained GP. A medical practitioner, who holds a GMS contract on foot of the 2009 interim entry provisions, will be entitled to accept on to his or her list any patients nominating him or her as their doctor of choice. The viability of existing GP practices in an area will no longer be a factor in awarding GMS contracts. The Bill when enacted will encourage competition among GPs at a time when private patients have considerably less money at their disposal.

In my constituency for example fees for GPs' charges range from €45 to €55 and these charges have not decreased since 2007 at the height of the boom when almost all charges have been reduced and when many public services paid for by the people have reduced significantly. The time has come to introduce competition into this service to allow the market dictate price. The Competition Authority recently stated:

The changes to the system for GPs treating medical card holders announced by the Minister for Health Dr James O'Reilly yesterday are good news for patients. These changes will impact on all patients, medical card holders and those who pay the full cost of visiting a GP.

Last year the Competition Authority called for exactly these changes to this system. In a report published in July 2010 the Competition Authority highlighted the fact that competition between GP practices and access to GP services were limited by elements of the medical card system. We recommended a number of changes which will lead to greater access to GP services and better choice and quality of service for all patients. They will also lead to increased value for money for consumers, the State and ultimately taxpayers.

The chairman of the Competition Authority, Declan Purcell, said:

Not only will patients have more GP services available in their area, it should also stimulate competition between GPs, which up until now has not been as robust as it could have been. It also means that young Irish GPs can now set up practices here in Ireland, where there is a chronic shortage of doctors, instead of having to emigrate.

The Government decision to fulfil a commitment to abolish all restrictions on entry into the general medical card scheme will open up the market and provide the general public and in particular the fee-paying patient with a clear choice and the possibility of a reduced cost, which is welcome when according to statistics 23% of the public do not have either a medical card or private medical insurance.

To be balanced on this debate it is worth noting that many GPs provide a fantastic service in their particular catchment areas with a vast secretarial back-up and the provision of a staff nurse. These practices are exemplary in their professionalism and the service the give the patient. It is noted that all of these services are paid for out of whatever the GP earns from the GMS. I am sure that doctors who are providing that level of service with competitive charges will continue to flourish when this Bill hopefully becomes law.

I compliment the Minister on the speed in bringing this legislation before the House. Many commentators are quick to point out the Minister's past association with his profession's association, the IMO, as a lobby group for GPs, but clearly this is the first Minister who has taken on the issue of opening up the sector to competition and in doing so has perhaps opened the way for major consumer savings on GP costs especially for middle-income families who do not have access to a medical card and for that I thank the Minister and commend the Bill to the House.

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