asked the Minister for Health the ratio of doctors to population in the choice of doctor scheme; and if he believes that this ratio is acceptable.
Ceisteanna—Questions. Oral Answers. - Choice of Doctor Scheme.
8.
At 30th September, 1972, the ratio of doctors to eligible persons in the choice of doctor scheme was 1 to 720, approximately. I consider this ratio to be satisfactory.
9.
asked the Minister for Health the estimated cost of the choice of doctor scheme for the first full year since its inception; if the cost will exceed the original estimate approved by his Department and, if so, by how much; and if he will indicate the factors which have contributed to any excessive cost.
As the Deputy is aware, the implementation of this scheme was a phased one. It was introduced in the Eastern Health Board area on 1st April last and in the rest of the country on 1st October. Assuming a continuation of the present level of demand on the service and no significant increase in the number of eligible persons, it is estimated that the general medical services will cost £8.5 million in the current financial year. This figure includes the cost of the dispensary service for the areas in which it was in operation up to 30th September and an appropriate amount of the cost of the public health nursing service. The estimate compares with an estimate of £7.5 million made for the current year in 1971 before the scheme commenced. Both figures include a provision of £0.5 million for a number of schemes to provide assistance towards the cost of prescribed medicines for persons not in the full eligibility category.
The main factors contributing to the higher estimate are (a) inflation in the prices of drugs and medicines and (b) excessive demands on the scheme in Dublin. Inflation accounts for about £½ million in the increase in the estimate. In general, for the area outside that served by the Eastern Health Board, it seems that adjustments in the original estimates for the present year will be those called for only to allow for inflation.
Can the Minister give an estimate of what it would cost in a full year, apart from this year, and can he say was the £7.5 million for this year or was it for a normal year's operations?
The £7.5 million was the estimate for this year in which the dispensary system operated in the whole of the country except for the Eastern Health Board area up to September 30th. It is impossible for me at this moment to anticipate the cost for next year. As the Deputy knows, we are in touch with the Medical Association, the Medical Union, and the Eastern Health Board, in order to make possible a reduction in the numbers of consultations in the Eastern Health Board area, in which there were nine visits per annum per each eligible person, and 16 items of prescription per eligible person, compared with 4½ consultations per person per annum in the rest of the country and a prescribing rate of about six prescriptions. Negotiations are taking place in order to bring down the number of consultations to a reasonable figure without any deterioration in the essential service to be provided.
May I ask the Minister——
I am calling Question No. 10.
——what reduction does he envisage as a result of these negotiations?
I could not possibly say. It is hoped to start the scheme for appointments in January next year. We will have to see how the scheme operates from then on.
Can the Minister say——
Would the Deputy appreciate that we have 192 questions on the Order Paper?
In some cases there are doctors who have a large number of very old people on their lists and therefore there is an exceptional number of consultations. Nothing can really explain the gross discrepancy between the average number of consultations in the Eastern Health Board area and elsewhere.
Has the Minister considered——
I have called Question No. 10. It is most unfair of the Deputy to monopolise Question Time in this way in view of the fact that there are 192 questions for answer on the Order Paper. It is a discourtesy to the House.
The Minister was very willing to reply to my supplementaries. The purpose of putting down questions is to elicit information, I would hope.