Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I thank Deputy Joe Carey for raising this issue and providing me with an opportunity to update the House on the matter. The Government is committed to ensuring that patients throughout the country continue to have access to GP services, especially in remote rural areas, and that general practice is sustainable in such areas into the future. On 1 January 2016, 15 GMS lists, out of a national total of more than 2,400, were without a permanent GP, and five of these were in rural areas. However, the full range of GP services continues to be provided to the patients in these areas through either a locum GP or a neighbouring GP.

The HSE, the Department of Health and the Irish Medical Organisation are engaged in a comprehensive review of the GMS and other publicly-funded health sector GP contracts. A key objective of the engagement with the IMO is to achieve revised and modernised contractual arrangements which support the sustainable delivery of enhanced GP services in local communities, especially in remote rural areas. As the Deputy pointed out, some 40 years have passed since the original contract was drawn up. Under the current GMS contract, GPs who practise in remote rural areas of low population qualify for special rural practice concessions, including an annual allowance of just over €16,200 and more favourable subsidies for the employment of staff, including practice nurses and secretarial support staff. The HSE recently produced revised rural practice allowance guidelines for remote rural areas. The purpose of the new guidelines is to ensure consistency, transparency and fairness in decision-making regarding rural GP practices and to provide additional options to support GPs. From time to time, HSE local offices offer other incentives, including access to HSE facilities, to attract GPs into rural areas. Such incentives may include offers of additional contracts, such as the contract to provide medical officer services to nursing homes.

I am aware that some isolated rural areas and deprived urban areas may find it difficult to attract GPs to fill vacant posts. I think this is what the Deputy is waiting for. I anticipate that the Department of Health and the HSE will shortly have a proposal to put to the IMO that will help to support and sustain rural practices. Although the existing rate of allowance for a single-handed GP is likely to be maintained, an enhanced allowance might be made available to GPs who are in group practice arrangements, for example, with GMS GPs outside the designated remote area but proximate to that area. In addition, we will propose special items of service to modernise the current arrangements and incentivise the provision of certain primary care services, such as new and emerging contraceptive methods. Having regard to the easing of the State's financial position, the Department of Health will shortly commence a formal consultation process under the FEMPI Acts in respect of the fees and allowances that are payable to contracted GPs. I emphasise that we feel we will shortly be in a position to make a proposal that - it is hoped - will find favour with the IMO in relation to rural practice and distance codes.

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