asked the Minister for Health if the Irish Medical Organisation has yet responded to the proposals he made on 7 October 1987 for a new agreement concerning the employment of doctors in the general medical service; and if he will indicate the way in which the present terms of employment of such doctors outlined in his reply to Parliamentary Question No. 101 of 22 October 1987 compare with the equivalent terms of doctors working in the National Health Service in Northern Ireland.
Written Answers - General Medical Service Doctors.
30.
The Irish Medical Organisation submitted a memorandum on 14 December 1987 in response to the proposals I had outlined at a meeting with the organisation on 7 October. The organisation's document and my original proposals are the subject of ongoing negotiations between the parties.
As outlined in my reply to a parliamentary question on 22 October last, general practitioners participating in the general medical services scheme are, in the main, remunerated on a "fee per item of service" basis. The scheme provides free general practitioner services to some 37 per cent of the population although this percentage varies on a regional basis. The remaining 63 per cent of the population make their own arrangements for the provision of general practitioner services.
In contrast, the provision of general practitioner services in the United Kingdom differs, both in regard to the scope of eligibility and the terms and conditions under which general practitioners provide services.
The British NHS provides free general practitioner services to the entire population as of right. In fact 99 per cent of the population is registered with a general medical practitioner under the scheme. This means that the amount of private practice is negligible. It follows therefore that practically all British general practitioners have a wholetime commitment to their NHS practices.
The mode of payment of general practitioners under the British NHS involves a mix of (i) capitation payments (ii) annual allowances (iii) specific allowances and (iv) special service fees. Currently the capitation payment accounts for about 4 per cent of the general practitioners earnings with the balance comprising allowances and fees.