Michael McGrath (Cork South Central, Fianna Fail)
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Question 78: To ask the Minister for Health and Children the number of live full medical cards and general practitioner visit cards in issue on a county basis; the number of persons covered by such cards; and the average annual cost to the Health Service Executive of a full medical card and a GP visit card. [9720/10]

Mary Harney (Dublin Mid West, Independent)
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Details of the number of medical card and GP visit card holders are provided to my Department each month by the Health Service Executive (HSE). The figures are provided on a net basis, showing the balance after new cards have been issued and other cards, as appropriate, have been deleted from the Executive's database, e.g. following a review of a person's circumstances. The most recent figures provided by the HSE to my Department reflect the position on 31st December 2009 and show 1,478,560 medical card holders and 98,325 GP visit card holders on that date.

There are two main cost factors associated with medical cards and GP visit cards, firstly the capitation and other payments made to General Practitioners (GPs) and, secondly, the cost of drugs supplied to patients.

GPs who hold contracts under the General Medical Services (GMS) Scheme with the Health Service Executive (HSE) are remunerated through a range of fees and payments, most of which were amended in the Health Professionals (Reduction of Payments to General Practitioners) Regulations 2009, which came into effect on 7th July last. Included among these fees are more than 50 different capitation fees. The fees vary depending on the age and gender of the patient and the distance he or she lives from the GP's surgery. For example, fees currently range from €76.98 for a male patient under 5 years living 3 miles or less from the GP's surgery to €218.37 for a female aged 65-70 years living more than 10 miles from the surgery. In addition, there are special capitation rates of €280.31 for persons over 70 residing at home and €896.07 for persons over 70 residing in private nursing homes. There is also a range of additional payments; for example, in respect of out-of-hours consultations, temporary residents, special items of services (e.g. suturing), panel size, practice support allowances and locum expenses.

As regards the supply of drugs and medicines, medical card holders receive these free of charge while GP visit card holders avail of the Drugs Payment Scheme, which now involves a co-payment of the first €120 spent per family in any calendar month. Drugs costs vary significantly depending on the patient's medical condition.

Given that there were 1,478,560 medical card holders and 98,325 GP visit card holders on the 31st December 2009, the variety of payment arrangements and the variation in drug costs, a single average annual cost figure in respect of the medical card and GP visit card is not a sufficiently refined measure for policy options and decisions.

For the Deputy's information, estimated total expenditure in 2009 on the GMS Scheme (medical cards and GP visit cards) was approximately €1.9 billion.

As parts of the information sought by the Deputy are not provided by the HSE to my Department as a matter of routine, my Department has requested the Parliamentary Affairs Division of the Executive to arrange to address these matters and to have a reply issued directly to the Deputy.