Written Answers. - General Medical Services Scheme.
Noel Ahern
Question:
38
Mr. N. Ahern
asked the
Minister for Health
the number of doctors currently working within the medical card scheme on a county by county basis; the number of patients covered by each doctor in each of the ranges 500 to 1,000, 1,001 to 1,500, 1,501 to 2,000 and more than 2,000; the number of other general practitioners or family doctors who are interested in having medical card patients; the reason this is not allowed; his views on whether competition and choice would be beneficial; his further views on whether doctors should be allowed retain their patients when they get a medical card; and if he will make a statement on the matter.
[11362/96]
Limerick East): The statistical information sought by the Deputy on the number of doctors in the general medical services (GMS) scheme, by county was as follows at 4 June 1996.:
|
Health Board
|
County
|
No. General Practitioners
|
|
Eastern
|
Dublin
|
434
|
|
Kildare
|
44
|
|
Wicklow
|
48
|
|
Total
|
|
526
|
|
Midland
|
Laois
|
25
|
|
Longford
|
13
|
|
Offaly
|
23
|
|
Westmeath
|
35
|
|
Total
|
|
96
|
|
Mid-Western
|
Clare
|
43
|
|
Limerick
|
76
|
|
Tipperary (NR)
|
24
|
|
Total
|
|
143
|
|
North-Eastern
|
Cavan
|
24
|
|
Louth
|
41
|
|
Meath
|
37
|
|
Monaghan
|
23
|
|
Total
|
|
125
|
|
North-Western
|
Donegal
|
63
|
|
Fermanagh
|
2
|
|
Leitrim
|
13
|
|
Sligo
|
32
|
|
Total
|
|
110
|
|
South-Eastern
|
Carlow
|
18
|
|
Kilkenny
|
31
|
|
Tipperary (SR)
|
45
|
|
Waterford
|
40
|
|
Wexford
|
53
|
|
Total
|
|
187
|
|
Southern
|
Cork
|
204
|
|
Kerry
|
66
|
|
Total
|
|
270
|
|
Western
|
Galway
|
105
|
|
Mayo
|
65
|
|
Roscommon
|
24
|
|
Total
|
|
194
|
|
National Total
|
|
1,651
|
The number of patients covered by each doctor in the panel ranges, as set out in the question, is as follows:
|
Patient range
|
500-1,000
|
1,001-1,500
|
1,501-2,000
|
2,001 and over
|
Totals
|
|
Health Board
|
No. of G.Ps.
|
Total no. patients
|
No. of G.Ps.
|
Total no. patients
|
No. of G.Ps.
|
Total no. patients
|
No. of G.Ps.
|
Total no. patients
|
G.Ps.
|
Patients
|
|
EHB
|
170
|
121,634
|
82
|
99,276
|
42
|
71,297
|
3
|
6,129
|
297
|
298,336
|
|
MHB
|
32
|
24,323
|
31
|
37,140
|
7
|
11,590
|
0
|
0
|
70
|
73,053
|
|
MWHB
|
72
|
53,615
|
26
|
30,876
|
6
|
10,716
|
0
|
0
|
104
|
95,207
|
|
NEHB
|
37
|
28,900
|
53
|
63,815
|
15
|
25,093
|
0
|
0
|
105
|
117,808
|
|
NWHB
|
38
|
27,147
|
34
|
40,690
|
16
|
26,593
|
1
|
2,024
|
89
|
96,454
|
|
SEHB
|
97
|
72,949
|
27
|
32,410
|
16
|
27,569
|
0
|
0
|
140
|
132,928
|
|
SHB
|
111
|
83,099
|
46
|
56,284
|
9
|
15,467
|
0
|
0
|
166
|
154,850
|
|
WHB
|
80
|
61,852
|
46
|
55,931
|
8
|
13,834
|
1
|
2,091
|
135
|
133,708
|
|
Grand Total
|
637
|
473,519
|
345
|
416,422
|
119
|
202,159
|
5
|
10,244
|
1,166*
|
1,102,344
|
(* Note:— This figure does not include G.P.s. with panels of less than 500 patients)
The above statistical information relates to the number of medical card patients on the panels of doctors who are contracted under the GMS scheme. Information on the number of non-medical card patients on doctor's panels is not available.
Under the Health Act, 1970, health boards are obliged to provide, without charge, a general practitioner medical and surgical service for persons with full eligibility — i.e. medical card holders. The Act and Regulations made under the Act in 1972, provide that, in so far as is practicable, a person availing of such services shall have a choice of medical practitioner.
The criteria agreed with the Irish Medical Organisation (IMO) in relation to the creation or filling of posts in the general medical services scheme (GMS) are:— (i) health boards are required to make appointments to the degree necessary to provide a proper level of access to general practitioner services for eligible patients; (ii) health boards are required to ensure that patients have a reasonable degree of choice in selecting a practitioner; and (ii) the viability of practices in the locality is taken into account.
Entry by doctors to the GMS scheme is by open competition for new posts which are created, vacancies which arise or for posts of assistant-with-a-view to partnership. Participating doctors enter into a contract with the relevant health board for the provision of services for medical card patients who choose to be on their panel. Doctors who do not hold such a contract are precluded from providing GMS services other than a locum to a participating doctor. There were 1,655 general practitioners participating in the GMS scheme as at 31 December 1995.
While it is understood from a survey currently being undertaken by the Irish College of General Practitioners that there are approximately 2,700 doctors in this country who regard themselves as general practitioners, accurate information on the number of doctors who are interested in obtaining a GMS contract is not readily available.
Entry for doctors to the GMS by way of open competition is a key principle of the scheme for the purposes of maintaining a high quality general practitioner service and an orderly development of services for patients. I am satisfied that the arrangements in place governing entry to the GMS scheme by general practitioners provide for a reasonable level of choice for patients and an efficient use of available resources.
