Jack Wall (Kildare South, Labour)
Link to this: Individually | In context

Question 127: To ask the Tánaiste and Minister for Health and Children the ratio of patients to doctors, general practitioners, medical card holders, private patients as determined by her Department; the mechanism determined by her Department in allocating areas for general practitioners services; the mechanism determined by the Department in accepting doctor's applications for dealing with medical card-holders; and if she will make a statement on the matter. [6133/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

The Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes responsibility for the assessment of service requirements for its area and ensuring that arrangements are in place to guarantee appropriate service delivery for its general medical services scheme, or medical card, patients.

In the case of general practitioners who hold contracts with the local area of the Health Service Executive to provide general practitioner services to medical card holders under the general medical services, GMS, scheme, the total number of patients which might be assigned to a doctor may be up to 2,000. In exceptional cases this limit may be exceeded or indeed a lower limit may be determined, but the decisions will be matters for the local area of the Health Service Executive to make, having regard to all of the aspects of the particular case.

Arrangements in respect of the provision of services by general practitioners who wish to solely provide services for private patients are matters for the doctor concerned and the local area of the health service is not involved in any way in this decision.

Where full GMS GP contracts are advertised, applications from suitably qualified general practitioners are invited. The procedure regarding the interview, selection and recruitment forms part of the GMS contract which participating doctors hold with their local Health Service Executive's area, and which is as agreed between the Department of Health and Children and the Irish Medical Organisation, the doctors' representative body. As part of industrial relations agreements between the Department of Health and Children and the Irish Medical Organisation, made in 1999 and again in 2001, limited entry to the GMS scheme was possible for suitably qualified GPs. These agreements allowed for those GPs who were interested and qualified to hold limited GMS contracts. These limited GMS contracts allowed GPs to treat their over-70s patients who qualified for a medical card for the first time, following the phased increase in the income level for eligibility assessment in 1999, and again following the introduction of the statutory entitlement to a medical card for all persons aged 70 years and over from 1 July 2001. After specified periods GPs holding these limited contracts would become eligible for full GMS contracts and be able to provide services to any medical card patient who might choose to be included on their patient panel list.

The 2003 annual report of the GMS Payments Board, now the HSE's primary care reimbursement service, is the latest for which published figures are available. The report indicated that at the end of 2003, there were 1.158 million eligible persons and 1,971 doctors participating in the GMS scheme, giving a ratio of 587.5 patients per doctor.