asked the Minister for Health the present stage in the negotiations with the IMO on payment to doctors in the GMS.
Ceisteanna — Questions. Oral Answers. - IMO Pay Negotiations.
3.
Proposals for a new contract for doctors participating in the GMS were put to the Irish Medical Organisation by my Department. Following the organisation's recent AGM, a meeting which had been scheduled with my Department was postponed by the organisation. A new date has yet to be set by the organisation.
I understand, however, that the proposals were not acceptable to the members of the IMO at their AGM. If this is so I would regard it as a matter of deep regret, since the proposals represented a means of strengthening general practice by diverting some of the money currently spent on drugs into investment in support staff and continuing education. The new style of practice envisaged in the proposals would emphasise prevention and patient education within a pattern of fewer but more meaningful consultations. If this opportunity is lost patients, doctors themselves and the taxpayer will have lost out. It will also be necessary then for me to consider what action I must take to remedy some of the defects of the present system which cannot be allowed to continue to operate.
Did I understand the Minister to say that he regretted that the doctors had not accepted a scheme whereby if they saved on the cost of the drugs which they prescribed for their patients it would improve their conditions of service?
I very much regret the attitude of the IMO at the annual general meeting. I am not sure how many attended that meeting, but the decision is that they did not accept my proposals, or at least that there was hostility towards them. That is unfortunate, but the IMO and I will have another meeting, I gather, in December, following which they will be coming to me with their further decision. I am prepared to wait until then, but certainly not much longer because the Estimates for 1986 and the work which must be done in this area cannot be delayed in that fashion.
The Minister has not answered the question. In the earlier part of his reply I understood him to say — and I understood that this was one of the proposals from his Department — that if the medical profession curtailed the cost of drugs which they prescribe for patients, their conditions of service would be improved with the money so saved.
That was so. That is the proposal which has been rejected.
Surely the Minister would not object to the medical profession not accepting that proposal?
I must negotiate——
Would the Minister agree that it is not in the interests of the public that there should be an incentive of that nature to doctors, that they curtail the prescribing of drugs for patients?
We seem to be debating the answer now.
No, I am asking a question.
In brief, the proposals I am putting to the IMO, which were approved by the Government prior to my putting them because of the substantial sums involved, meant a reduction in drug costs of about £15 million. Of that sum, about £8 million would go to the doctors by way of higher fees, grants for the employment of support staff in their practices and payment for participation in continuing education, which is very necessary in GP practice. The other £7 million would go to meeting the other contingencies. For example, in the GMS this year there is already a £5 million overrun. Frankly, after patient negotiation for two years, the end of the road is coming and if these efforts are not successful we will introduce other measures. We have no option but to do so.
Arising out of the last comment of the Minister, has he ever taken the opportunity of visiting a surgery of any doctor within the GMS and observing the number of patients there? Has he devised some method whereby he can tell patients to go home on that day because they are over-visiting their doctors? If so, will he tell them that on a particular day at a particular stage they have now exhausted their visiting rate for the year? That is what he has been trying to say.
That is comment on the answer.
Briefly, the visiting rates for the GMS for this year have risen significantly.
Why?
There are many interesting reasons for that, not the least of which are the negotiations going on.
The economic policies of the Government.
We could be debating this matter all day. I call Question No. 4.