Éamon Ó Cuív (Galway West, Fianna Fail)
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628. To ask the Minister for Health the full year cost of restoring distance coding and increasing the allowance to €25,000 under the rural practice allowance. [26759/16]

Simon Harris (Wicklow, Fine Gael)
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Regulations were signed on 5th May 2016 which provide for the introduction of the new Rural Practice Support Framework, which includes improved qualifying criteria for rural support and an increase in the financial allowance from €16,216.07 to €20,000 per annum. The Regulations also revise the list of Special Items of Service, which are made available to patients under the General Medical Services (GMS) scheme.

Under the new Framework, if two practice units are providing general practitioner services in the same qualifying area, both practices may qualify for a modified allowance of €10,000. GPs holding a permanent GMS contract who received the Rural Practice Allowance of €16,216.07 immediately prior to the introduction of the new Regulations who do not meet the new qualifying criteria continue to receive the payment on a personal basis, provided they retain their contractual commitment to the remote rural area.

As at 8th September 2016, there are 253 practice units in receipt of rural supports under the RPSF. 175 practices receive the financial allowance of €20,000 and 20 practices receive the modified allowance of €10,000. The full year cost of increasing the existing allowance to €25,000 and the corresponding modified allowance to €12,500 for these practices would amount to nearly €1 million. Any increase in the financial allowance under the new RPSF would only apply to those practices that qualify under the new criteria, therefore these calculations have excluded the 58 GPs who currently receive the old financial allowance of €16,216.07.

Since 2009, a number of reductions have been applied under the Financial Emergency Measures in the Public Interest Act 2009 (FEMPI) to the fees and allowances paid to healthcare professionals, including GPs who provide services under the GMS scheme. The “distance code” was removed as a factor in calculating GP fees and allowances in 2010 under FEMPI. Certain fees payable to GPs such as capitation and out of hours fees varied according to a patient's age, gender and distance of their residence from the GP's surgery.

To accurately cost a reinstatement of the previous "distance code" arrangement would require a detailed exercise by the HSE, which would involve establishing a database for the current population of GMS patients containing their age, gender and distance of their residence from their GP's surgery. The Primary Care Reimbursement Service, which is responsible for the remuneration of GPs for the range of services they provide under the GMS scheme, does not currently maintain such a database. Therefore, it is not possible to provide a cost estimate in respect of this element of the Deputy's question.