asked the Minister for Health whether his Department have made any assessment of increased annual cost arising out of the fee per item of service scheme; if he will state the provisional estimate of the increase; whether the increase will result in economies elsewhere in the service; and, if so, if he will indicate the areas where economies will be effected.
Ceisteanna—Questions. Oral Answers. - Health Service Fees.
9.
It is estimated that the annual increase in the cost of providing general medical services for eligible persons as a result of the introduction of the choice of doctor scheme will be of the order of £500,000 to £600,000.
Apart from other benefits I would hope that the new arrangements will lead to a more economic usage of drugs and medicines. The operation of a central computerised system of payment for prescriptions dispensed by the retail pharmacists participating in the scheme will make it possible to exercise closer supervision over that aspect of the service. Certain savings will also arise in the distribution costs of medicines and in rentals and maintenance of dispensary premises and residences no longer required for use in the service.
Will the Minister state on what the figure of £500.000 was based? On what number of items of service per annum was it based?
I have not those figures. It was the nearest estimate we could make.
The Minister has the figures and he knows on what he based that figure. That is a lie. I say it is a lie. I know the Minister knows it.
The Deputy will withdraw that statement.
The Deputy must withdraw the word "lie".
I think it is incorrect.
The Deputy will withdraw the word "lie" please.
I withdraw the word "lie". I know it is untrue because the Minister has the figures and he knows on what he based that figure. The Minister should be more co-operative and should give more information on it.
Surely the Minister is not telling the House that he has a figure and he does not know the origin of the figure? Has he any idea at all of the basis of calculation of the figure?
I have some idea of how the figure was based but I do not have it in the reply. It was not asked. Surely it is quite enough for Deputies to know the extra cost. It is a very approximate estimation. I cannot say how many doctors will take part in the fee for service arrangement if the ballot is successful. If the ballot shows an approval by the Medical Association and the Medical Union, I cannot say how many doctors will take part in this service. It is a voluntary matter for them. The health boards themselves have to approve the contracts. The whole of that system has to be put into operation so that any figures I have would be so approximate they would be hardly worth giving to the House. It was based on a number of alternative assumptions.
The Minister has decided on a basic fee and this is for an item of service. If he comes up with a figure of £500,000 he must know the number of items of service per annum per patient. He knows that and he should tell us what the figure was based on.
It depends how many patients go to the doctors.
The Minister must have some information on that.
Our estimate was based on what we thought would happen.
Would I be right in saying to the Minister that he based it on three and a half items of service per annum?
Something of that order. The fact is that it is conjectural. We do not know how many patients will go to the doctors; we do not know how many doctors will take part in this scheme.
Is it also conjectural to give a figure of £500,000?
Question No. 10. We cannot discuss this matter all evening.
I obviously had to make some estimate.