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

We need to be careful about the language we use. There are 18 vacancies in total and percentages can often give a false view when one is talking about a small cohort of people. All 18 vacancies are covered by locums. In some cases, as this has been on a prolonged basis, they will not be unfamiliar to the people they see on a daily basis. There is, however, an issue, with which we are not unfamiliar. We recently had two meetings on the subject.

I thank the Senator for raising this issue, as it provides me with an opportunity to update the House on it. I am very much aware of the issues facing general practice in rural areas. My colleague, the Minister for Health, Deputy Leo Varadkar, and I recently held separate meetings with the Irish Medical Organisation and the National Association of General Practitioners, at which we discussed general practice in rural areas, among other things. Under the general medical services capitation contract, GPs are eligible for a rural practice allowance when they live and practise in an area with a population of less than 500 where there is not a town with a population of 1,500 or more within a radius of 4.83 km of that centre and where the HSE considers it necessary to pay an allowance to retain a doctor in the area. The rural practice allowance under the capitation agreement is currently set at just over €16,000 per annum. GPs who satisfy the criteria for payment of the allowance are also entitled to claim practice support subsidies towards the employment of a practice nurse, secretary and manager at the maximum applicable rate which they would otherwise only be entitled to claim if they had a panel size of 1,200 and over. Qualifying GPs can also claim the maximum applicable contribution towards locum costs for periods of leave such as sick, annual, study, maternity and adoptive leave.

The HSE has recently reviewed its guidelines for dealing with applications for a rural practice allowance from GPs applying for a GMS contract in a rural area. The purpose of the new guidance is to ensure consistency, transparency and fairness in decision-making in respect of the relevant discretionary provisions of the GMS contract pertaining to the granting or otherwise of the allowance to new applicants. The new guidance does not, however, affect existing holders of the allowance. The HSE, the Department of Health and the IMO are engaged in a review of the GMS and other publicly funded health sector contracts involving GPs. The review is taking place within the context of the framework agreement which was signed by the parties in June 2014 and the memorandum of understanding signed in February 2015.

Among the topics comprehended by the review is the issue of supports for general practice in rural areas. With regard to the reversal of fee reductions introduced under the Financial Emergency Measures in the Public Interest Act 2009, FEMPI, I recognise that general practice has contributed its fair share under the Act, some €122 million, but others in society, including other health professionals, have also played a pivotal role in the country's recovery. A review will take place shortly of the fee adjustments introduced under the FEMPI legislation for contracted professionals in the health sector, including GPs. This follows on from engagement earlier this year between the Minister for Public Expenditure and Reform and public sector unions on an orderly unwinding of the legislation.

There is a lot of information included in my reply. This is not an issue about which we are unconcerned or with which we are unfamiliar. We hope that, through negotiation and regular contact, there will be some improvements.