I propose to take Questions Nos. 111, 124 and 134 together.
The Office of the Data Protection Commissioner has not raised concerns with the Department of Health or the HSE about sections of the draft agreement for the provision of services to children under six years that relate to the exchange of information between General Practitioners (GPs) and the HSE. However, it is the HSE's intention to consult with the Office of the Data Protection Commissioner with a view to ensuring that the contract, when finalised, is fully compliant with the requirements of data protection legislation.
The Department and the HSE have been working collaboratively for a number of years with the Irish College of General Practitioners (ICGP), under the auspices of the General Practitioner Information Technology (GPIT) Group, to further enhance the already impressive level of ICT deployment in general practice. Examples of the initiatives that are being progressed in general practice include specialist electronic referrals, general electronic referrals, secure e-mail, the management of client indices and electronic diagnostic messaging. Other potential areas where ICT deployment would be of benefit include electronic prescribing, clinician decision support functionality, electronic registers to support the management of chronic diseases, and shared electronic records to support the integrated care of patients within the primary care setting and between primary and secondary care clinicians.
It is envisaged that the draft contract for children under 6 years, when finalised, will facilitate the continued deployment of technology based solutions in general practice. In this context, it is hoped that the GPIT group will continue to fulfil its key collaborative role in facilitating the introduction of ICT initiatives through the consensus based approach that has worked well over the past number of years. In a similar vein, it is intended that the contract, in its final format, will support and encourage GPs to observe cost effective prescribing through, inter alia, decision support technology, as well as evidence based support and guidance from the HSE Medicines Management Programme. The provisions on prescribing practice in the draft contract are not intended to impose unwarranted interference on a GP's clinical judgement and autonomy. The details around how prescribing initiatives will be implemented will involve extensive and focused engagement with GPs who are, I believe committed to the efficient use of resources to ensure that we achieve the best possible outcomes for patients.
The concept of performance reviews is a well-recognised feature of contracts for service and for this reason has been included in this draft contract. I have noted the comments received on this matter as part of the public consultation process and I am open to accommodating the views of the key stakeholders in the final contract.
Regarding the publication of a revised draft contract, I am keen to ensure that the draft contract is subjected to a rigorous consultative process and I am quite prepared to amend the document, as appropriate, based on the feedback and commentary received. In this context, I have written to the Irish Medical Organisation (IMO) to assure them that the Department and the HSE are fully prepared to engage meaningfully with them and are prepared to negotiate with them on all aspects of the scope and content of the proposed contract. I have also explained that there will be an opportunity for their input on the fee structure, which will be addressed by means of a related consultation process.
I trust that the IMO will accept my invitation to commence negotiations with the Department and the HSE. I am confident that a process of open discussion has the potential to significantly enhance the draft contract for patients, GPs, the HSE and the Department, thus helping to progress our common goal of free GP care at the point of access.