Responsibility for the provision of general practitioner services under the General Medical Services Scheme (GMS) rests with the chief executive officers of the health boards. The current arrangements governing entry to the General Medical Services Scheme were agreed with the Irish Medical Organisation in August 1989. Vacancies arising or new posts created under the GMS are filled to the degree necessary to provide a proper level of access to general practitioner services for medical card patients and to ensure that patients have a reasonable degree of choice in selecting a practitioner having due regard to the viability of practices in the area in question.
Entry to the scheme is by way of open competition and contracts under the scheme are offered to general practitioners who are successful following competition between suitably qualified applicants.
Patient choice is an important tenet of the GMS Scheme. It is the medical card holder who selects the participating doctor whom he/she wishes to provide general practitioner services. The current GMS contract sets a limit on the number of patients which may be placed on a doctor's list. An upper limit of 2,000 applies except in exceptional circumstances and a health board which contracts with individual doctors for the provision of services to GMS patients may specify a lower limit in certain circumstances.