I propose to take Questions Nos. 156, 208 and 209 together.
The indicative drugs target savings scheme, IDTSS, was introduced from 1 January 1993 and was developed in line with health policy. The IDTSS is a negotiated agreement between the Irish Medical Organisation and the Department of Health and Children. The agreements provide that both parties are committed to the achievement of responsible and cost effective prescribing.
Under the terms of the IDTSS individual doctors can accrue savings which may be used to fund capital developments in their practices which provide additional or enhanced services impacting on patients. These include information technology, practice premises, clinical equipment, research, education, training and recruitment of extra primary care expertise on fixed term contracts, for example, paramedical, counselling etc. Savings made cannot be used to subsidise normal practice expenses. Health boards are required to evaluate and approve applications from participating GPs for the use of the savings made under the IDTSS.
The national distribution of payments under the scheme from the time of its commencement to 31 August 2004 is set out on a county basis in the following tabular form:
County
|
Amount Paid from GP Savings
|
|
€
|
Carlow
|
866,946
|
Cavan
|
1,191,695
|
Clare
|
2,439,633
|
Cork
|
9,566,826
|
Donegal
|
9,620,500
|
Dublin
|
18,867,368
|
Fermanagh
|
11,531
|
Galway
|
4,460,066
|
Kerry
|
3,274,138
|
Kildare
|
679,692
|
Kilkenny
|
1,271,250
|
Laois
|
677,511
|
Leitrim
|
2,232,230
|
Limerick
|
3,719,965
|
Longford
|
1,088,539
|
Louth
|
2,519,932
|
Mayo
|
6,002,893
|
Meath
|
2,450,963
|
Monaghan
|
737,643
|
Offaly
|
592,387
|
Roscommon
|
1,986,573
|
Sligo
|
2,558,230
|
Tipperary
|
1,923,209
|
Waterford
|
4,791,394
|
Westmeath
|
1,424,218
|
Wexford
|
3,067,881
|
Wicklow
|
2,133,409
|
TOTAL
|
90,156,620
|
In 1997 a review of the IDTSS was completed by Michael Murphy, professor of pharmacology at University College, Cork. The purpose of the review was to determine the effects of the IDTSS on the quality of patient care in the GMS with particular reference to changes in prescribing patterns. The review found that there were changes in prescribing behaviour as a result of the indicative drugs target savings scheme. Some doctors made savings through enhanced prescribing of generic medications and there were no discernible negative effects on overall quality of prescribing.