I propose to take Questions Nos. 568 and 569 together.
Under the General Medical Services (GMS) scheme, general practitioners are reimbursed for the services they provide to medical card and GP visit card holders. The scheme provides a range of supports for GPs. In addition, the 2019 GP Agreement provides for additional and enhanced supports as well as a significant increase in investment in general practice over the lifetime of the agreement.
Under the GMS scheme GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary. The rate payable depends on the GP's GMS panel size and the level of experience of the nurse or secretary. A practice manager subsidy is also available. GPs working in rural areas who meet the qualifying criteria will qualify for an annual rural support allowance. In addition, locum expenses are provided to cover various GP leave expenses.
The 2019 Agreement on GP contractual reforms will see the Government increase investment in general practice by approximately 40% (€210 million) between 2019 and 2023, providing for significant increases in capitation fees for GPs who participate in the reform programme and the introduction of new fees and subsidies for additional services such as the chronic disease programme. The rural support allowance has been increased for participating GPs, an additional support has been introduced for GPs working in disadvantaged urban areas, and improvements have been made to maternity and paternity leave arrangements.