Vol. 413 No. 7
13 Mr. Currie asked the Minister for Health if she will outline the basis on which instructions were issued to general practitioners requiring them to reduce the availability of prescribed drugs to medical card patients; and if she will make a statement on the matter.
No instruction has been issued to general practitioners requiring them to reduce the availability of prescribed drugs to medical card holders.
In the course of the 1990-91 review of the GMS contract, it was agreed between the Irish Medical Organisation and management that, as part of a co-ordinated drugs strategy, indicative prescribing budgets would be determined for all doctors in the GMS scheme. It was further agreed that these budgets would be based on the best information available and that they would be refined and adjusted annually. This process has now commenced and indicative figures were circulated to doctors for a six month period this year, prior to the circulation of the annual targets for 1992 which will be determined following discussion with the Irish Medical Organisation.
The cost of prescribing in the GMS has risen from £79.5 million in 1986 to an estimated £118 million in 1991.
In general, the 1992 target figures for individual practices will take account of the total amount available for the GMS and standard costs having regard to panel size and demography.
I stress that the target figures will not interfere with the right of doctors to prescribe as they consider necessary but will allow them to objectively assess their overall prescribing levels with comparable practices.
Does the Minister agree that the hasty instruction issued to general practitioners in August was not in accord with the terms agreed with the medical profession? Would she further agree that it was totally hamfisted to issue a directive in August about drug reductions which showed the usage for May only, and not for June and July and to expect doctors to make massive cuts in prescribing levels? Finally, would the Minister not agree that asking doctors to cut their prescribing rate for public patients by 30 per cent discriminates between public and private patients in their access to medical care?
As I have already said, in the 1990-91 review of the GMS contract agreed between the Irish Medical Organisation and management it was agreed that as part of a co-ordinated drugs strategy indicative prescribing budgets would be determined for all doctors in the GMS scheme and that this process would be refined and adjusted annually. This refining and adjustment process is continuing.
May I take it then that the Minister considers that the attempt in August was a hamfisted effort to deal with this problem?
No, not at all.
I was surprised to hear the Minister say that no instructions have been issued, because we are all aware, as I hope the Minister is, that instructions were issued to doctors. We accept the need to prescribe generic drugs. A hamfisted attempt was made to curtail doctors prescribing drugs in the middle of the year when doctors would have no opportunity to curtail their prescription rate without risking the health of their patients.
The information available to me is that no instruction has been issued to general practitioners requiring them to reduce the availability of prescribed drugs to medical card holders. However, a review was carried out in 1991 and as part of a co-ordinated drugs strategy it was agreed that indicative prescribing budgets would be determined for all doctors in the GMS scheme.
I now call Question No. 14.
May I ask a question?
We are not going to have a debate on this issue. The Deputy is not entitled to ask a supplementary question.
I thought I was.
There is no such entitlement.
I used to be so allowed.
The Chair decides whether supplementary questions will be allowed.
The Chair used to let me raise such matters.
