The position is that there is a comprehensive list of essential drugs and medicines under the general medical services (GMS) scheme, which are available free of charge to medical card holders, on foot of a general practitioner's prescription. A number of products, generally those available without prescription on an over-the-counter (OTC) basis, are not available under the scheme. Approximately 15 representations are received each year by my Department on behalf of members of the public seeking to have OTC products included on the list of items reimburseable under the scheme. As a prescription is not required for OTC items, the question of a doctor refusing to prescribe these products does not arise.
With regard to the second element of the Deputy's question relating to incentives for doctors to prescribe efficiently and effectively, I should point out that the indicative drug target (IDT) scheme was introduced for general practitioners contracted under the general medical services (GMS) scheme on 1 January 1993. The introduction of the IDT scheme followed a review of the GMS scheme in 1992 by the Department, the health boards, the Irish Medical Organisation, and the Irish College of General Practitioners.