I propose to take Questions Nos. 159, 161, 165, 170 and 171, together. The Deputy will be aware that the Review of the General Medical Service is now underway and that in the context of that review a wide range of issues of concern to participating general practitioners are under consideration. These issues include the manner in which withholding tax is applied to general practitioners, the implementation of the 17.5 per cent arbitration award to GMS doctors, the possibility of introducing innovative pilot projects such as prescribing budgets for individual practices and the question of adapting the existing GMS contract to reflect the particular difficulties being experienced on the ground in different geographic locations. While I do not wish to comment in detail on any specific matter currently under discussion in the context of the Review, I can assure the Deputy that all of the issues raised in his questions will be given full and detailed consideration by the management side representatives.
I received Government approval to the acceptance of the Arbitrator's findings on GMS doctors' fees on the basis that the implementation of the findings would be negotiated in the context of the current GMS contract discussions, as suggested by the Arbitrator in his report and that on the successful completion of these discussions, the revised rates will be paid on 1 December 1992 with full retrospection on 1 January 1993. This decision has been conveyed to the Irish Medical Organisation.
In relation to the reimbursement of medical indemnity insurance the position is that arising out of the recommendations of the 1990 Interim (Horgan) Review of the 1989 GMS contract all participating doctors have a portion of their medical indemnity insurance refunded. Following a recent meeting with the Association of General Practitioners I decided, in equity, to extend this arrangement to the small number of fee-per-item doctors not comprehended by the 1989 contract. At that meeting I was presented with a submission from the Association in relation to the withholding tax issue which I agreed to forward to the Minister for Finance and to the GMS Review for consideration.