Jack Wall (Kildare South, Labour)
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Question 339: To ask the Minister for Health and Children the guidelines given by her Department or the Health Service Executive on personal house calls to medical card holders by general practitioners; the linkage between such guidelines and the availability of the doctor support groups who are in position through out the country to attend after surgery calls; and if she will make a statement on the matter. [11762/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Under the General Medical Services (GMS) Scheme contract, between individual general practitioners and the Health Service Executive (HSE), GPs are obliged 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 emergencies outside of these hours.

The question of whether a domiciliary visit is appropriate is a matter for decision by the GP according to the clinical need, social and other circumstances in any particular case.

GP out-of-hours co-operatives allow general practitioners to put in place arrangements to provide services to their patients outside normal surgery hours in the evening, on weekends and bank holidays. The development of GP co-operatives is in line with the overall health service policy of strengthening primary care services and ensuring that to the greatest extent possible, people's care needs are met in the primary care setting.

GP out-of-hours co-operatives are now in place in all HSE areas, providing coverage in all or in part of all counties and the HSE Vote includes some €37 million in baseline funding for these services. This figure does not include the fees of the participating doctors.

Persons who contact GP out-of-hours co-operatives are prioritised as either emergency, urgent or routine. In emergency cases a triage nurse will organise the appropriate care for the patient and will generally arrange for the dispatch of an ambulance and/or duty doctor. For non-emergency calls a triage nurse carries out a structured assessment by telephone of the patient's symptoms, after which home care advice may be provided or the nurse may make an appointment for the patient to be seen by the duty doctor at a treatment centre or, if necessary, a home visit may be arranged.