I propose to take Questions Nos. 242 to 247, inclusive, 249, 256, 258 to 264, inclusive, and 268 to 271, inclusive, together.
The current agreement with General Practitioners (GPs) to provide services under the General Medical Services (GMS) Scheme was introduced in 1989.It has been updated over the years through a number of circulars, which can be found on-line at:
http://www.icgp.ie/go/in_the_practice/information_technology/egms.
The current rates of payments are set out in the Health Professionals (Reduction of Payments to General Practitioners) Regulations 2010 (S.I. 638/2010).The fee payable to GPs for attendance at HSE-convened case conferences is €67.05.Under the Financial Emergency Measures in the Public Interest Act 2009, fees and allowances payable to GPs, which were reduced in 2009 and 2010, will be reviewed before the end of this year.
The full list of GMS payments to GPs for the years 2007 to 2009 is set out in the Primary Care Reimbursement Service (PCRS) "Statistical Analysis of Claims and Payments", which can be viewed on-line at http://www.hse.ie/eng/staff/PCRS (PCRS Publications 2007, 2008 and 2009 — Page 37 — Table 3).The PCRS report for 2010 has not yet been published.
The GMS Contract makes provision for the appropriate refund of medical indemnity insurance to contracted doctors, based on the size of the GP's panel.The refund is calculated as a percentage of the net premium paid by the GP. To qualify, the GP must produce evidence of payment of medical indemnity insurance.(Circular 1/92 dated 10th January 1992; revised in Circular 5/96 dated 22 July 1996).
The Contract makes provision for payments for locum cover while a GP is on leave (Circular 4/89 dated April 1989), including annual leave (revised in Circular dated 5th June 1997) and study leave (revised in Circular 2/90 dated 2 February 1990 and Circular 2/95 dated 6th February 1995).
The Contract makes provision for the payment of subsidies towards the cost of employing practice nurses, secretaries and managers (revised in Circular dated 7th June 1995; Circular 6/96 dated 23rd July 1996; Circular dated 5th June 1997; Circular dated April 1998; Circular dated 31st July 2001; and Circular dated 8th April 2002.)
In 1993, the Government agreed to the establishment of a General Practice Development Fund (Circular 1/93 dated 6th January 1993).The following payments were made to GPs out of the fund:
1. Payments for the provision of rostering and out-of-hours arrangements.
2. Payments towards practice maintenance, equipment and development.
3. A supplementary grant to employ practice nurses and secretaries.
Under the Health Professionals (Reduction of Payments to General Practitioners) Regulations 2010, separate payments under these headings are no longer made. Under the Contract, GPs are eligible for a Rural Practice Allowance when he/she lives and practices in an area with a population of less than 500, where there is not a town with a population of 1,500 or more within a three mile radius of that centre and where the HSE considers it necessary to pay an Allowance to retain a doctor in the area.
My Department has requested the Parliamentary Affairs Division of the Executive to arrange to address the other aspects of the Deputy's questions, including information which is not provided by the HSE to my Department as a matter of routine, and I will convey this information to the Deputy as soon as I have received it.