Under the terms of the GMS scheme, contracting doctors are required to work a certain number of hours and to be available at other times in instances where their patients have emergency needs. Clearly, particular doctors cannot be available at all times and the issue of providing appropriate cover for their patients therefore arises, especially in so-called out of hours situations, that is late at night, weekends, public holidays etc.
Throughout most of the country, the provision of such cover has traditionally been provided through rota arrangements operated by doctors and encouraged by health boards. In the Dublin and surrounding areas, there are also certain localised rota arrangements in place in certain locations but in other areas of the capital region, GPs have tended to use a bureau service or doctor on-call service. The latter two arrangements involve the participating GPs concerned in paying a certain fee to the commercial service operators to provide cover facilities. In all cases, rota arrangements and bureau and on-call services are private arrangements organised and operated to allow doctors meet their obligations to their patients, both private and public, when they are themselves unavailable.