Dáil Éireann debate -
Tuesday, 11 Mar 1997

Vol. 476 No. 2

Written Answers. - Indicative Drug Prescribing.

Ivor Callely

Question:

76 Mr. Callely asked the Minister for Health his views on the opinion that indicative drug prescribing by doctors is an action of responsibility for the proper health care of a patient to secure a remunerative advantage, either personally or in respect of a department or unit; and if he will make a statement on the matter. [6615/97]

Minister for Health (Mr. Noonan,

Limerick East): I presume the Deputy is referring to the indicative drug target (IDT) scheme which was introduced for general practitioners in the general medical services (GMS) scheme on 1 January 1993, following the review of the scheme in 1992 by the Department, the health boards, the Irish Medical Organisation, and the Irish College of General Practitioners.

In the course of the review mentioned above, it was agreed by all sides that medicines were not always prescribed in the most effective manner and that there was significant potential for an improvement in prescribing practice leading to better patient care and better use of the available resources in the development of general practice. Accordingly, each doctor was encouraged to examine his-her existing prescribing practices with a view to availing of 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, for patients on their panels, which had been constructed on the basis of average prescribing costs weighted by age and sex criteria.

As an incentive to doctors, the IDT scheme provided that a portion of the savings effected would be made available to the individual doctor for practice development projects which received the prior approval of the relevant health board. The balance of the savings made is allocated to the relevant health board for investment in general practice projects within the board's area.

At every stage during the process of reaching agreement on the IDT scheme and in the subsequent implementation of that agreement, all the parties to the review mentioned above clearly understood and accepted that it was the duty and obligation of doctors, individually and collectively, to provide the most appropriate management and to optimally utilise the available resources for patient care. It was and is similarly understood and accepted that the right of the doctor to prescribe for the patient as he-she considers necessary, remains in place.

I am satisfied therefore, that the IDT scheme places the utmost importance on patient care from the viewpoint of safe, rational and cost effective prescribing. It is important to point out that the IDT scheme does not provide the general practitioner with a personal remunerative advantage, rather it provides a means for investment in his-her own practice in the first instance and for other practices in the health board's area. Such investment is to the advantage of all patients of general practitioners.