Rónán Mullen (Independent) | Oireachtas source

I would be grateful to the Leader if he were to arrange a debate, at the earliest opportunity, to discuss with the Minister for Health the provision of general practitioner services in rural areas. I have raised previously the rural practice allowance, which is a statutory scheme that has been in place since 1972, having been provided for in the Health Act 1970. The allowance is paid to general practitioners in rural areas to help them defray the higher costs of running a rural practice. These costs include the greater number of house calls rural doctors must make to older patients than doctors in urban areas. As I have noted previously, some general practitioners must act as dispensing agents of medicines in rural areas where pharmacists are not readily available.

The rural practice allowance is paid where a general practice is located at least three miles from a town or village with more than 1,500 people. I do not need to stress the importance of general practitioners in rural areas. A local medical service is vital to older persons living in relatively isolated areas with limited or no rural transport. Access to primary care locally helps to reduce the number of people who present at hospital accident and emergency departments.

I informed the House recently that it had come to my attention that the Health Service Executive was revising by stealth the terms of the statutory scheme under which the rural practice allowance is paid and systematically withdrawing the payment from general practitioners in rural areas. I have spoken to doctors in east County Galway and other rural areas about their concerns. The effect of the withdrawal of the allowance has been to leave some general practitioners in east County Galway and elsewhere in the west without an economic basis for continuing to provide their services. It is common knowledge that it is proving nearly impossible to attract young doctors to establish general practices in rural areas.

Since I last raised this issue, it has been reported in the media that one general practitioner in the west took the HSE to court to compel it to pay the rural practice allowance. Other doctors have come forward indicating that their rural practice allowance payments have been similarly withdrawn. This is disgraceful. If the Government is serious about the provision of medical services in rural areas, it should call a halt to the withdrawal by stealth of allowances for general practitioners. The HSE is acting in a high-handed and arbitrary manner in the way in which it is administering and restricting a scheme the Oireachtas has laid down in law. I would be grateful if the House could hear from the Minister for Health on this matter.