Martin Heydon (Kildare South, Fine Gael) | Oireachtas source

I thank the Senator for raising this important issue and one which, I know from my discussions with him, is of major concern to him and his constituents in Cork.

Under the general medical services, GMS, contract, GPs must be available to provide services in their practice premises or by way of domiciliary visits, as appropriate, for their medical card and GP visit card patients for 40 hours each week. They must also make arrangements to enable contact to be made with them, or a locum-deputy, for urgent cases outside these hours.

While there is no obligation on GPs to participate in GP out-of-hours co-operatives as a means of meeting the contractual requirement, such services have been developed and expanded over time and are now an essential and positive part of primary care services. This helps to ensure that, to the greatest extent possible, urgent care needs are met in the primary care setting.

SouthDoc provides a Saturday morning service in most areas in the Cork-Kerry region. This service has been advanced incrementally in recent years in response to requests from various local out-of-hours cells. The majority of areas are now included in the Saturday morning service. However, there are a number of areas where the Saturday morning service is being provided by individual practices, as opposed to being operated by SouthDoc.

Following engagement with the Irish Medical Organisation, a grant-based system of funding for GP out-of-hours co-operatives has been in place since March 2020 to support out-of-hours services during the pandemic. In accordance with the agreed system, no out-of-hours or other claims for consultations during a co-operative's hours of operation are claimable by the co-operative or its members from the HSE primary care reimbursement service, PCRS. The PCRS has a legal obligation to ensure resources are used for the purpose for which they are intended and is obliged to verify the reasonableness and accuracy of all claims submitted for payment. A validation mechanism exists for claims made by co-operative members during the hours of operation of grant-aided co-operatives.

The PCRS has provided a specific email address and a contact point for GPs who may have any queries or concerns regarding the validation mechanism or their GMS remuneration. If GPs who are not co-operative members, or who do not have co-operative cover available to them, are inadvertently captured by the PCRS validation process, they should notify the PCRS straightaway. Where a GP can provide information that clarifies that any claim held under the validation mechanism is in line with the GP's contract, then the PCRS will ensure that the claim is paid.

I have been informed that Cork Kerry Community Healthcare has recently learned of the decision by the PCRS to cease payments to GPs who are running their Saturday morning service outside the SouthDoc co-operative. Cork Kerry Community Healthcare is currently determining the specifics and will be engaging with the GPs who have notified it of this issue, as well as the other stakeholders as a matter or priority. Cork Kerry Community Healthcare is working locally with all stakeholders to ensure appropriate and safe service levels are maintained. This involves a level of detail regarding contracts and State processes. As the Senator knows, with regard to the systems, the PCRS and others need to make sure that funds are dedicated to where they should go. I completely take on board the concern this issue is causing locally with healthcare providers on the ground and their patients, the Senator's constituents, who are concerned about medical cover into the future. I will be working with ministerial colleagues to ensure the concerns the Senator raised are highlighted and that there is detailed ongoing negotiation and contact with all the relevant parties to make sure this issue and the potential impasse are resolved.