Dáil Éireann Debate, Thursday - 23 May 2013
206. Deputy Jack Wall asked the Minister for Health the reason the Health Service Executive is not paying general practitioners to administer warfarin to qualified patients in view of the fact that, if they were to attend the clinics as determined by the HSE, this would create a major travel cost for each participant; and if he will make a statement on the matter. [24833/13]
View answerThe current General Medical Services (GMS) GP Capitation Contract was introduced in 1989 and is based on a diagnosis and treatment model. Under the GMS contract, GPs receive a range of fees and allowances, including an annual capitation payment in respect of each medical card and GP visit card patient on their GMS list. Section 11 of the current contract states as follows: "The medical practitioner shall provide for eligible persons, on behalf of the relevant Health Board, all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess. This will include such preventive and developmental services as are currently provided or may be developed in the new style of practice which this agreement facilitates, some of which services may be included on the list of special items of service for which specific payments shall be made."
The monitoring and appropriate care of patients receiving anti-coagulation therapy with Warfarin comes within the scope of competence of general practice. Warfarin testing is also available free of charge in hospitals. Warfarin testing is carried out by some general practitioners as a matter of course in their practices and I welcome this. This provides their patients with an option of receiving this service locally in a primary care setting rather than attending an acute hospital for this service.
The Programme for Government provides for the introduction of a new GMS GP contract with an increased emphasis on the management of chronic conditions, such as diabetes and cardiovascular conditions. It is envisaged that the new contract, when finalised, will focus on prevention and will include a requirement for GPs to provide care as part of integrated multidisciplinary Primary Care Teams. Officials in my Department are in consultation with the HSE with a view to drawing up a new contract. The appropriate arrangements in relation to anti-coagulation therapy will be considered as part of the new contract.
