Vol. 434 No. 2
360 Mr. Sheehan asked the Minister for Health if his attention has been drawn to the fact that the Southern Health Board has decided not to fill the vacant position of general practitioner in the Castletownbere area owing to financial constraints; and in view of the effect this decision will have on the inhabitants of the Beara Peninsula, including Bere Island and Dursey Island, if he will issue a directive and appropriate finance to the board to fill this vacancy.
The decision to fill a vacancy or to dissipate a general medical services panel on the retirement of a participating general practitioner is a management function of the chief executive officer of a health board. In exercising this function a chief executive officer must ensure that patients have a proper level of access to general practitioner services and a reasonable degree of choice in selecting a general practitioner having due regard to the question of viability of practices in the area in question.
I had inquiries made of the Southern Health Board and I am informed that the doctor referred to by the Deputy who retired from the GMS scheme in August, 1993 had her principal centre of practice at Castletownbere, County Cork. Her GMS panel consisted of 115 patients, which was a particularly small panel relative to panel sizes in the board's area where the average panel size is approximately 650 patients.
I understand that there are two other doctors participating in the scheme whose principal centre of practice is also Castletownbere. Given the number of GMS patients in the Castletownbere area, including the islands referred to by the Deputy, the board is satisfied that these participating doctors will provide an effective general practitioner service for all GMS patients in line with the criteria set out above. Accordingly, the board was satisfied that there was no necessity to appoint a replacement doctor. Patients on the panel of the retired doctor are being transferred to one of the participating doctors of their choice in the area. The Irish Medical Organisation was consulted prior to the decision of the board.
In relation to the question of funding, the Deputy will be aware that the principal system of remuneration of participating doctors under the GMS is by way of capitation payments per individual patient. Accordingly, medical card patients who were on the panel of the retired doctor will continue to avail of general practitioner services under the scheme and in respect of which capitation payments will continue to be made. In such circumstances, funding to support the general practitioner services for these patients was not relevant to the board's decision.
