I propose to take Questions Nos. 315 and 316 together.
Under the Health Act 2004, the Health Service Executive (HSE) has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes responsibility for the selection and recruitment of general practitioners to provide services under the contract to persons covered by the General Medical Services (GMS) Scheme. Entry to the GMS Scheme for general practitioners is normally through open competition and interview following advertisements in national and medical newspapers. All suitably qualified persons may apply for these positions.
The HSE is required, under the terms of the agreement negotiated with the Irish Medical Organisation (IMO), when deciding to fill a vacant GP patient panel or to create a new patient panel, to take account of the potential viability of such a panel under a range of headings including:
The number of GMS patients on the list
The age/sex profile of the patients on the list
The geographic area in which the practice is situated
The number and age profile of the GMS doctors in the area, and their list sizes
The private practice profile of the area in question, including the ratio of private to public patients in the area.
The population size in the area and surrounding areas.
The factors advanced by the applicant doctor in support of his/her application.
The particular public health needs of the area in question.
Under the terms of further agreements reached in the context of the extension of medical card coverage to all persons aged 70 and over, and the introduction of the GP visit card, arrangements were made permitting GPs who at that time did not hold a GMS contract to obtain a contract in respect of providing a service to such patients, with an option to become eligible for a full GMS contract in due course.
Under the terms of the agreements with the IMO, the number of persons whose names may be placed on a GP's panel may not exceed 2,000 save where the HSE, in exceptional circumstances, and after consultation with the IMO, decides to apply a higher limit.
I regard these existing arrangements as unnecessarily restrictive and it is my wish, therefore, that new contractual arrangements which are to be developed for the provision of publicly funded general practitioner services should ensure that HSE contracts are open to all suitably qualified and equipped doctors.