I propose to take Questions Nos. 35 and 68 together.
My Department investigates complaints about the prescribing of controlled drugs by general practitioners in the context of the Misuse of Drugs Act, 1977. Arising from these investigations I have the power to set up a special committee of inquiry in individual cases to investigate each case in greater detail, after which inquiry I may issue a special direction prohibiting that general practitioner from prescribing certain controlled drugs. Under the Act there is also provision for the findings of such inquiries to be relayed to the Medical Council so that it may take whatever further action it considers necessary in relation to the general practitioner.
The Misuse of Drugs Act, 1977 does not provide for a limit on the number of patients for whom an individual general practitioner can prescribe. The question of taking action in relation to patient numbers does not therefore arise.
The report of the Expert Group on the Establishment of a Protocol for the Prescribing of Methadone set out recommendations for the involvement of general practitioners and community pharmacists in methadone maintenance programmes. It recommended that general practitioners should become involved by taking on responsibility for the care of opiate dependent persons who had first been stabilised at community drug treatment centres. It also outlined the criteria necessary to ensure that methadone prescribing occurred in a controlled, responsible fashion. Many elements of the protocol have been implemented. Most notably, a central treatment list of patients being prescribed methadone has been established. Under this arrangement a general practitioner who is considering prescribing methadone for a patient can check whether the patient's name is on this treatment list and so minimise the possibility that the patient concerned is receiving methadone from more than one source. However, it was only in the report of the Review Group of Methadone Treatment Services, which was published in January, 1998 that recommendations were made regarding limits on the number of patients that a general practitioner should treat.