asked the Minister for Health if it is considered desirable that doctors should be excluded from participation in the GMS scheme, unless they have seven years' full-time practice served in the one area.
Ceisteanna—Questions. Oral Answers. - GMS Scheme Doctors.
10.
The primary method of entry by doctors to the General Medical Service is by open competition among doctors, with not less than two years post-graduate experience, for vacancies arising in the scheme.
Since 1975, to facilitate the establishment of partnerships, doctors may apply for advertised posts as assistant with a view to partnership and participation in the scheme.
A doctor established in practice in a centre for seven years, who has not entered the scheme by open competition of through a partnership has an automatic right of entry at that stage. In general, I consider these methods of entry adequate to meet the needs of the General Medical Service.
Is the Minister not aware that in a number of instances doctors who have been in practice for a period of less than seven years in one area feel aggrieved that they have not the right of entry to the scheme and they feel also that patients eligible for the scheme in that area have not the same choice of doctor because of the fact that they are not allowed to participate in the scheme?
I have outlined the system which has been in operation and which, as far as I know, is reasonably satisfactory from the point of view of the services as such. Any alterations in that scheme would be a matter to be discussed with the Medical Union and the Irish Medical Association.
Has the Minister had any representations from an organisation which was formed to represent these excluded doctors?
I know of no such organisations. Any discussions that I am aware of would be with the Medical Union or with the Irish Medical Association.
Is it a fact that in some cases doctors who become partners in practice with a doctor who is operating under the scheme attend medical card patients although they have not got seven years' experience?
That is implicit in my answer.
Is that not an anomaly?
I said that since 1975, to facilitate the establishment of partnerships, doctors may apply for advertised posts as assistants with a view to partnership and participation in the scheme.
Does it not seem to be unfair that a doctor in partnership who has been practising for a shorter period than seven years may not take part in the scheme although a person with seven years' experience can?
Such a doctor would be going as a partner to an experienced doctor.
Is the Minister not aware that since last year's IMA general meeting it is their policy that the period of seven years should be reduced to three years? Has the Minister had representations from the IMA to that effect?
I have not said whether I have had representations. I said these are matters to be discussed between the authority responsible for the general medical service and the professional bodies concerned.
Has the Minister had any representations from the IMA?
Discussions are going on continuously on the scheme.
Is the Minister saying he has not had representations from the IMA?
Any discussions I have had with the IMA are between that body and me.
(Cavan-Monaghan): Does the Minister not think that seven years is a bit long? Is it not a very substantial period in the life of a doctor?
I do not know. There may be a case for the adoption of a shorter period, but in this instance we have to try to keep a balance between a number of conflicting considerations. First of all there is the patient, whose interests should be paramount. Number two, there is the necessity to have an efficiently administered scheme. Then there is the legitimate interests of the doctors. The system in operation has been hammered out with a view to getting satisfaction all round. If these conditions are to be changed, I suggest the matter should be agreed between the professional bodies and the general medical service authorities.
(Cavan-Monaghan): The doctor in private practice would be on his own and he would be attending private patients. In this instance he would be required to have seven years' experience before being allowed to participate in the scheme. I suggest that it is too long and that consequently some areas are not as well served in regard to the choice of doctor scheme as they should be.
Ten questions in half-an-hour is a bit long, too.
The different interests and considerations have to be taken into account. This is not a clear-cut case. I am not saying that if all the professional bodies and everybody else concerned agreed the system should not be changed.
(Cavan-Monaghan): The Minister has just said that the interests of the patients should be paramount.
The thing we must see to is that we do not have too many young doctors crowding into populous areas, starting up practices, giving inadequate service from everybody's point of view and having the less populated areas of the country neglected. The Deputy's points will be kept in mind.
Question No. 11.