Fergus O'Dowd (Louth, Fine Gael)
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Question 28: To ask the Tánaiste and Minister for Health and Children if she intends to implement any recommendations made in a report (details supplied), if so, if she will report on the recommendations she intends to implement; and if she will make a statement on the matter. [9485/05]

Fergus O'Dowd (Louth, Fine Gael)
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Question 58: To ask the Tánaiste and Minister for Health and Children if, as recommended by a report (details supplied), she intends to radically review the expenditure under the medical card and other State medical schemes, including the long-term illness and drug refund schemes; if so, when she intends to carry out such a review; and if she will make a statement on the matter. [9484/05]

Joe Costello (Dublin Central, Labour)
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Question 105: To ask the Tánaiste and Minister for Health and Children her views on the recently published Review of Governance and Accountability Mechanisms in the General Medical Service (details supplied), particularly in regard to its findings on the issuing of medical cards to the over 70s; the action, she intends to take on foot of the report's findings; and if she will make a statement on the matter. [9402/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 28, 58 and 105 together.

The review was commissioned by my Department with a view to analysing governance and accountability mechanisms in the general medical service, GMS, schemes, the respective roles of the Department, former health boards and the former GMS payments board in the operation of the schemes, and issues relating to the increasing cost trends in the GMS generally. Since the review was completed a number of important reforms have taken place in the health sector to give effect to a number of its recommendations.

The establishment of the Health Service Executive on 1 January 2005 has given a practical effect to the recommendations in relation to governance and financing of the GMS schemes, through the creation of a unified management structure for the general medical service. All aspects of the management and operation of the schemes will now be through the primary, community and continuing care and shared services directorates of the executive.

Specific recommendations of Deloitte & Touche which are being advanced under the auspices of the HSE include: a programme to introduce a national client index. This index will avoid the data integrity issues which came to light at the time of the extension of medical card eligibility to all over 70s; and a programme to standardise the business processes around the medical card scheme and to examine the ICT and technical requirements for the modernisation of this scheme. This will also be extended to the community drugs schemes.

The HSE will provide a unified structure to standardise the business processes and provide the necessary technical support structures. Both programmes are being led by a dedicated team of HSE officials under the auspices of the national schemes modernisation group.

In response to the recommendations regarding the need for improved financial forecasting procedures for the GMS schemes, the forecasting model has been adapted by the HSE shared services — primary care reimbursement service to allow for three-year forecasting.

In the light of the recommendations regarding the cost of the GMS, further detailed ongoing analysis is being carried out by my Department in conjunction with the Department of Finance, and with the assistance of the former GMS payments board, now the HSE shared services — primary care reimbursement service to identify policy options for managing the unsustainable growth in expenditure recorded in the schemes, including the cost implications of the decision to extend medical card eligibility to all over 70s.

In addition, the then Minister for Health and Children in February 2004 established a national drugs prescribing group to evaluate proposals in relation to the control of drugs costs contained in the review and other reports, for example, Brennan, to determine their feasibility and early delivery as part of the health reform agenda.

These exercises will form the basis for initiatives to control costs in the context of the overall care strategy. All aspects of the drug delivery system from the manufacturer to the patient are currently under review. This, along with the two reports mentioned above, will form an important ongoing input into the determination of policy priorities for the GMS schemes and for their cost-effective management by the HSE.