Michael Ring (Mayo, Fine Gael)
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Question 156: To ask the Tánaiste and Minister for Health and Children the person who monitors the interests of medical card holders in relation to the indicative drug target savings schemes; if they are represented in this scheme; if only her Department and doctors are represented; and if she will make a statement on the matter. [29655/04]

Beverley Flynn (Mayo, Fianna Fail)
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Question 208: To ask the Tánaiste and Minister for Health and Children the accountability that exists on the operation of the indicative drug target saving scheme, to ensure that the savings under the scheme are being used to benefit the patients of general practitioner practices. [30238/04]

Beverley Flynn (Mayo, Fianna Fail)
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Question 209: To ask the Tánaiste and Minister for Health and Children if she will provide details on the indicative drug target savings scheme in regard to the savings since the scheme began in 1993; the breakdown in the savings on a county by county basis; and her views on the fact that this represents the best use of taxpayers money. [30239/04]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 156, 208 and 209 together.

The indicative drugs target savings scheme, IDTSS, was introduced from 1 January 1993 and was developed in line with health policy. The IDTSS is a negotiated agreement between the Irish Medical Organisation and the Department of Health and Children. The agreements provide that both parties are committed to the achievement of responsible and cost effective prescribing.

Under the terms of the IDTSS individual doctors can accrue savings which may be used to fund capital developments in their practices which provide additional or enhanced services impacting on patients. These include information technology, practice premises, clinical equipment, research, education, training and recruitment of extra primary care expertise on fixed term contracts, for example, paramedical, counselling etc. Savings made cannot be used to subsidise normal practice expenses. Health boards are required to evaluate and approve applications from participating GPs for the use of the savings made under the IDTSS.

The national distribution of payments under the scheme from the time of its commencement to 31 August 2004 is set out on a county basis in the following tabular form:

In 1997 a review of the IDTSS was completed by Michael Murphy, professor of pharmacology at University College, Cork. The purpose of the review was to determine the effects of the IDTSS on the quality of patient care in the GMS with particular reference to changes in prescribing patterns. The review found that there were changes in prescribing behaviour as a result of the indicative drugs target savings scheme. Some doctors made savings through enhanced prescribing of generic medications and there were no discernible negative effects on overall quality of prescribing.