Vol. 443 No. 3
69 Mr. Cullen asked the Minister for Health if he has satisfied himself that the substantial savings made under the indicative drug prescribing scheme were not made at the expense of patient care; and the plans, if any, he has to deduct retention tax on the savings made by general practitioners under the indicative drug prescribing scheme.
81 Mr. Gilmore asked the Minister for Health if his attention has been drawn to reports that one medical practice participating in the GMS drugs budgeting scheme in the Eastern Health Board area came in £100,000 under budget; his views on whether such underspending is in the interests of the practice's patients; the plans, if any, he has to review the scheme in view of this figure; and if he will make a statement on the matter.
I propose to take Questions Nos. 69 and 81 together.
In discussions with the Irish Medical Organisation in the context of the GMS review it was agreed that, in common with other developed countries, medicines are not always prescribed in the most effective manner in this country and that, accordingly, there was significant potential for an improvement in prescribing practice leading to better patient care and better use of the resources in the development of general practitioner services.
Each doctor was, accordingly, encouraged to examine his-her existing prescribing practices with a view to availing of any available opportunities to make prescribing more effective and less costly for all his-her patients. To assist in this process doctors were provided with indicative drug targets which had been constructed on the basis of average prescribing costs weighted on the basis of age and sex.
The duty and obligation of individual doctors to provide the most appropriate management for each patient who presented and, in so doing, to utilise resources available for the optimum care of patients individually and collectively was emphasised by all parties to the scheme. In this context the right of the doctor to prescribe as he-she considers necessary remains absolutely in place and there is no limitation on the range of items from which he-she can choose to prescribe. As an incentive to doctors to embark on this review process the scheme provided that 50 per cent of all savings made by GPs on his-her target expenditure would be returned to the GPs for investment in agreed practice development.
The end of year figures for expenditure on drugs and medicines in the GMS scheme in 1993 showed that expenditure in 1993 increased over the 1992 outturn figure by just 2.64 per cent, a significant improvement on the trend increase of an average of 11 per cent per annum which had been evidenced over the previous five years.
