General Practitioner Data

Questions (188)

Louise O'Reilly

Question:

188. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of directly employing one, ten and 50 general practitioners, respectively, inclusive of salary and PRSI costs. [27338/19]

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Written answers (Question to Health)

General Practitioners (GPs) are not employees of the HSE but are private practitioners contracted to provide services on behalf of the HSE, to people with Medical Cards, GP Visit Cards and various other schemes.

Under the General Medical Services (GMS) contract, GPs are reimbursed for a range of services they provide to medical card and GP visit card holders. GPs are remunerated for these services primarily on a capitation basis, with a range of additional support payments and fees for specific items of service.

As the HSE does not directly hire GPs and currently there is no approved salary scale in the public service for a GP post, it is not possible to quantify the financial implications for the HSE of additional GPs being hired to provide services to the public health system under the GMS and other schemes.

General Practitioner Data

Questions (189, 191)

Louise O'Reilly

Question:

189. Deputy Louise O'Reilly asked the Minister for Health the estimated cost and breakdown of providing practice nurses to work with 50 general practitioners; and the estimated cost of their training and pay for work for a first and full-year period. [27339/19]

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Louise O'Reilly

Question:

191. Deputy Louise O'Reilly asked the Minister for Health the estimated cost and breakdown of providing medical secretaries to work with 50 general practitioners including the cost of their training and pay for work for a first and full-year period; and if he will make a statement on the matter. [27341/19]

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Written answers (Question to Health)

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.

General Medical Services Scheme Expenditure

Question No. 191 answered with Question No. 189.

Questions (190)

Louise O'Reilly

Question:

190. Deputy Louise O'Reilly asked the Minister for Health the cost paid by the State for a general practitioner visit under the general medical services scheme. [27340/19]

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Written answers (Question to Health)

Under the General Medical Services (GMS) contract, GPs are reimbursed for a range of services they provide to medical card and GP visit card holders.

GPs are remunerated for these services primarily on a capitation basis rather than a per-visit basis, with a range of additional support payments and fees for specific items of service. It is therefore not possible to calculate the cost of a general practitioner visit under the GMS contract.

The table below outlines the current indicative annual cost for GP visit card eligibility and medical card eligibility, by age group.

Age Group

Cost per GP Visit Card

Cost per Medical Card

0 – 4 Yrs

€243

€390

5 – 15 Yrs

€165

€268

16 - 44 Yrs

€154

€688

45 – 64 Yrs

€223

€1,286

65 – 69 Yrs

€252

€1,663

Aged 70 and over

€500

€2,130

Note: Indicative costings compiled by the HSE Primary Care Reimbursement Service, based on claims for the 12-month period to December 2018.

Question No. 191 answered with Question No. 189.

General Practitioner Training

Question No. 194 answered with Question No. 160.

Questions (192, 193)

Louise O'Reilly

Question:

192. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of expanding the specialist training fund for higher specialist trainees scheme for general practitioners in first and second year giving €500 per year as is the case for third and fourth year trainee general practitioners. [27342/19]

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Louise O'Reilly

Question:

193. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of increasing the specialist training fund for the higher specialist trainees scheme from €500 to €600 for general practitioners in third and fourth year. [27343/19]

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Written answers (Question to Health)

I propose to take Questions Nos. 192 and 193 together.

Currently only year 3 and year 4 GP trainees are eligible for the Higher Specialist Trainee (HST) Fund. The cost of increasing the payment by €100 for the 2018-2019 year would be €33,900 for 339 GP trainees.

The Higher Specialist Training fund does not extend to those in basic speciality training, however if €500 was provided to year 1 and year 2 GP trainees for the 2018-2019 year, this would amount to a further €173,500 for 347 GP trainees.

I would note that the HST scheme relates to all higher trainees and if it was expanded and increased by the amounts suggested, it would cost significantly more when the increase is applied to all HST trainees.

Additional Training Supports Funding (TFS) is being made available to all NCHDs from July 2019 as a result of the 2016 IMO High Court Settlement and a MacCraith Report recommendation which acknowledged the need for a more differentiated model that takes account of the needs and costs associated with various specialities and stages of training.

This new Training Support Scheme will give Year 3 and year 4 GP trainees an additional €2,000 per year and year 1 and year 2 GP trainees an additional €1,250 per year.

Question No. 194 answered with Question No. 160.

Ambulance Service Data

Questions (195)

Louise O'Reilly

Question:

195. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of purchasing three fully equipped ambulances for each of the four HSE regions [27345/19]

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Written answers (Question to Health)

As this is a service issue, I have asked the HSE to reply to you directly.

Ambulance Service Data

Questions Nos. 197 to 200, inclusive, answered with Question No. 136.

Questions (196)

Louise O'Reilly

Question:

196. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of the required whole-time equivalent personnel for each of the 12 ambulances and the skill mix necessary. [27346/19]

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Written answers (Question to Health)

As this is a service issue, I have asked the HSE to reply to you directly.

Questions Nos. 197 to 200, inclusive, answered with Question No. 136.

Disability Services Data

Questions Nos. 202 and 203 answered with Question No. 182.

Questions (201)

Louise O'Reilly

Question:

201. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of providing an additional 500,000 hours under the personal assistant scheme. [27351/19]

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Written answers (Question to Health)

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Questions Nos. 202 and 203 answered with Question No. 182.