Written answers

Tuesday, 31 January 2017

Department of Health

General Practitioner Contracts

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry, Independent)
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599. To ask the Minister for Health his views on whether the FEMPI cuts as applied to general practitioners were discriminatory in that they were applied to the total allowances rather than just income which resulted in a 75% cut to the income thereby causing the current crisis in general practice; his plans to address this while awaiting the new general practitioner contract; and if he will make a statement on the matter. [4530/17]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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Under the General Medical Services (GMS) contract, GPs are reimbursed for a range of services they provide to medical card and GP visit card holders. GPs are remunerated for these services primarily on a capitation basis, with a range of additional support payments and fees for specific items of service. The amount payable in respect of certain of these supports is related to the doctor's panel size. GPs can also provide services to private patients if they wish. The arrangements and fees charged for such consultations are a matter of private contract between the patient and the GP and I have no role in relation to such private income for GPs.

As a consequence of the severe difficulties arising from the economic and fiscal crisis of recent years, between 2009 and 2013 a number of reductions were 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.

There have been significant developments in general practice service in recent years, with more services being made available to our citizens and additional financial support provided by the HSE. Developments include a universal GP service for all children under 6 years and all persons over 70 years, the introduction of a Diabetes Cycle of Care for adult patients with Type 2 Diabetes, an enhanced support framework for rural GPs and a revised list of special items of service to encourage the provision of more services in the primary care setting. Additional funding of over €100 million per annum has been provided to general practice to support the roll-out of these initiatives.

I envisage that, subject to the overall resources available to Government, commitments to the provision of additional State resources to general practice will be linked to the outcome of contractual negotiations on the expansion of the range of services encompassed by the GMS contract.

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry, Independent)
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600. To ask the Minister for Health the status of negotiations with general practitioners' representative organisations regarding a new contract (details supplied); and if he will make a statement on the matter. [4531/17]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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The development of primary care is central to the Government's objective to deliver a high-quality, integrated and cost effective health service. The Programme for Government commits to a decisive shift within the health service towards primary care in order to deliver better care close to home in communities across the country. The development of a new, modernised contract for the provision of general practitioner services will be a key element in facilitating this process.

Previous engagements have resulted in a number of service developments including the introduction of a Diabetes Cycle of Care for adult patients with Type 2 Diabetes, an enhanced support framework for rural GPs, and a revised list of special items of service under the contract to encourage the provision of more services in the primary care setting. These measures, combined with the under-6s and over-70s universal GP care initiatives, have increased the financial support for general practice.

The next phase of discussions on a new GP contract is under way and initial meetings with GP representative bodies were held in January. As with any negotiation-type process, and given the range and complexity of the issues to be discussed, the engagement may take some time. While I am of course anxious to see good progress made, it is not my intention to set a deadline for completion of discussions. It would be premature, in advance of substantive progress being made on the development of a new contract, to make statements in relation to funding.

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