I propose to take Questions Nos. 189 and 191 together.
Under the GMS scheme, GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary. Payment is made to participating doctors with a panel size of at least 100 patients and payment increases in bands of 100 with a maximum payment applicable at a panel size of 1,200. The subsidy rate applies to those staff employed on a full-time basis and for staff not employed on a full-time basis payment is made on a pro rata basis.
As the HSE does not fund practice nurse or practice secretary posts in full, the estimated costings provided below are based on the current level of subsidy payments and on the assumption that the GP has the maximum panel of 1,200 + patients.
The cost of the subsidy for 50 practice nurses would range between €1.55 million and €1.89 million and the cost of the subsidy for 50 practice secretaries would range between €1.03 million and €1.2 million depending on the experience of the nurse or secretary.
There is no provision under the terms of the current GMS contract to pay a subsidy for training practice nurses or practice secretaries, or to pay for locum cover in respect of any period of training.