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S.I. No. 638/2010 - Health Professionals (Reduction of Payments to General Practitioners) Regulations 2010.

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S.I. No. 638/2010 - Health Professionals (Reduction of Payments to General Practitioners) Regulations 2010.

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Notice of the making of this Statutory Instrument was published in
“Iris Oifigiúil” of 31st December, 2010.
I, MARY HARNEY, Minister for Health and Children, in exercise of the powers conferred on me by section 9 of the Financial Emergency Measures in the Public Interest Act 2009 (No. 5 of 2009), having complied with subsections (4), (7) and (13) of that section, with the consent of the Minister for Finance, hereby make the following regulations:
1. These Regulations may be cited as the Health Professionals (Reduction of Payments to General Practitioners) Regulations 2010.
2. In these Regulations—
“Capitation Agreement” means an agreement between the Health Service Executive and a general practitioner made in accordance with the conditions specified by the Minister for Health and Children in 1989 regarding the provision of services to eligible persons under section 58 of the Health Act 1970 (No. 1 of 1970) by general practitioners, as amended from time to time;
“day consultation” means a consultation during normal hours of a general practitioners surgery as agreed between the Health Service Executive and that general practitioner;
“Fee Per Item Agreement” means an agreement between the Health Service Executive and a general practitioner made in accordance with the conditions specified by the Minister for Health and Children in 1972 regarding the provision of services to eligible persons under section 58 of the Health Act 1970 (No. 1 of 1970) by general practitioners, as amended from time to time;
“late consultation” means a consultation other than a day consultation or a night consultation;
“night consultation” means a consultation during the period between midnight and 8 a.m. the following day.
3. These Regulations shall apply to payments in respect of services rendered by a general practitioner to or on behalf of the Health Service Executive under the General Medical Services Scheme, the Health (Amendment) Act 1996 , the Maternity and Infant Care Scheme and the Heartwatch Programme.
4. The amounts of the payments that shall be made to a general practitioner in respect of the services referred to in Regulation 3 from the date of the making of these Regulations shall be those specified in Schedules 1 to 18.
5. The Health Professionals (Reduction of Payments to General Practitioners) Regulations 2009 ( S.I. No. 262 of 2009 ) are revoked.
SCHEDULE 1
Services rendered under the General Medical Services (GMS) Scheme — Capitation Agreement — general practitioner capitation rates (all amounts inclusive of the former payments towards practice maintenance, equipment and development).
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Male patient aged under 5 years
€76.98
2.
Male patient aged 5 years or more and less than 16 years
€44.68
3.
Male patient aged 16 years or more and less than 45 years
€57.03
4.
Male patient aged 45 years or more and less than 65 years
€113.91
5.
Male patient aged 65 years or more and less than 70 years
€120.00
6.
Patient aged 70 years or more residing in the community
€280.31
7.
Patient aged 70 years or more residing in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks
€448.04
8.
Female patient aged under 5 years
€75.09
9.
Female patient aged 5 years or more and less than 16 years
€45.19
10.
Female patient aged 16 years or more and less than 45 years
€93.26
11.
Female patient aged 45 years or more and less than 65 years
€125.17
12.
Female patient aged 65 years or more and less than 70 years
€133.87
13.
Supplementary out-of-hours fee
€3.76
SCHEDULE 2
Services rendered under the General Medical Services (GMS) Scheme — Capitation Agreement — out-of-hours payments (in respect of consultations other than day consultations or consultations occurring as part of an overflow in respect of normal surgery hours) (all amounts inclusive of the former additional allowance for the provision of rostering and out of hours arrangements)
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Surgery consultation Monday to Friday (excluding public holidays) between the hours of 5 p.m. and 6 p.m. on the same day and 8 a.m. and 9 a.m. on the same day
€15.00
2.
Surgery consultation Monday to Friday between the hours of 6 p.m. and 8 a.m. the following day and any time on Saturday, Sunday and public holidays
€45.00
3.
Domiciliary visit out-of-hours
€45.00
4.
Surgery consultation or domiciliary visit out-of-hours where a GP sees an additional GMS patient during the same consultation or visit
€15.00
SCHEDULE 3
Services rendered under the General Medical Services (GMS) Scheme — Capitation Agreement and Fee Per Item Agreement — payments to a general practitioner (GP) in respect of temporary residents, EEA visitors and emergency consultations where a GP sees another GPs GMS patient in an emergency
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Surgery consultation
€44.26
2.
Domiciliary visit
€44.26
SCHEDULE 4
Services rendered under the General Medical Services (GMS) Scheme — Capitation Agreement — payments to a general practitioner (GP) in respect of special items of service
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Excisions/cryotherapy/diathermy of skin lesions
€26.81
2.
Suturing of cuts and lacerations
€26.81
3.
Draining of hydroceles
€26.81
4.
Treatment and plugging of dental and nasal haemorrhages
€26.81
5.
Recognised vein treatment
€26.81
6.
Electrocardiography (ECG) tests and their interpretation
€26.81
7.
Instruction in the fitting of a diaphragm
€26.81
8.
Removal of adherent foreign bodies from the conjunctival surface of the eye
€26.81
9.
Removal of lodged or impacted foreign bodies from the ear, nose and throat
€26.81
10.
Nebuliser treatment in the case of acute asthmatic attack
€40.23
11.
Bladder catheterization
€40.23
12.
Advice and fitting of a diaphragm
€45.13
13.
Counselling and fitting of an intra uterine contraceptive device (IUCD)
€72.21
14.
Attendance by GP at HSE-convened case conference
€67.05
SCHEDULE 5
Services rendered under the General Medical Services (GMS) Scheme — Capitation Agreement — allowance in respect of a general practitioner whose practice is eligible for a rural practice allowance
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Rural practice allowance (per annum)
€17,530.89
SCHEDULE 6
Services rendered under the General Medical Services (GMS) Scheme — Capitation Agreement — fees payable to a general practitioner (GP) for dispensing in accordance with the circular titled “Certain matters relating to the provision of services under section 58 of the Health Act 1970 ” dated 24 September 1999
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Opt-in GP (dispensing doctor)
€41.11
2.
Pilot GP (dispensing doctor)
€47.44
3.
Continuous GP (dispensing doctor)
€13.49
SCHEDULE 7
Services rendered under the General Medical Services (GMS) Scheme — Capitation Agreement — payment to a general practitioner for a second medical opinion
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Fee for second medical opinion
€28.60
SCHEDULE 8
Services rendered under the General Medical Services (GMS) Scheme — Capitation Agreement — maximum allowances in respect of practice support payable on the basis of a general practitioners GMS panel size (all amounts inclusive of the former supplementary grant to GPs who employ secretaries or nurses or both)
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Nursing subsidy (per year) — 1 years experience
€31,258.45
2.
Nursing subsidy (per year) — 2 years experience
€32,995.02
3.
Nursing subsidy (per year) — 3 years experience
€34,731.61
4.
Nursing subsidy (per year) — 4 or more years experience
€38,204.77
5.
Secretarial subsidy (per year) — 1 years experience
€20,838.96
6.
Secretarial subsidy (per year) — 2 years experience
€22,575.55
7.
Secretarial subsidy (per year) — 3 or more years experience
€24,312.12
8.
Practice manager subsidy (per year) — based on first point of nursing subsidy
€31,258.45
SCHEDULE 9
Services rendered under the General Medical Services (GMS) Scheme — Capitation Agreement — maximum allowances payable to a general practitioner (GP) in respect of locum expenses
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Annual leave (per day)
€213.23
2.
Annual leave (per week)
€1,492.60
3.
Sick leave (per day) during the first week
€213.23
4.
Sick leave (per week) for the first week
€1,066.14
5.
Sick leave (per day) from week 2 to week 26
€213.23
6.
Sick leave (per week) from week 2 to week 26
€1,492.60
7.
Sick leave (per day) from week 27 to week 52
€106.62
8.
Sick leave (per week) from week 27 to week 52
€746.30
9.
Study leave (per day)
€213.23
10.
Study leave (per week)
€1,492.60
11.
Maternity leave (per day)
€213.23
12.
Maternity leave (per week)
€1,492.60
13.
Paternity leave (per day)
€213.23
14.
Adoptive leave (per day)
€213.23
15.
Adoptive leave (per week)
€1,492.60
16.
Annual leave — former District Medical Officer: (a) maximum rate — payable for each of the first 3 days annual leave in a year (b) medium rate — payable for each of the next 25 days annual leave in that year (c) minimum rate — payable for each other annual leave day in that year
€71.86€61.47€52.88
17.
Statutory leave — meetings of statutory bodies (per day)
€213.23
18.
Attendance at Irish Medical Organisation GP meetings (per day)
€213.23
SCHEDULE 10
Services rendered under the General Medical Services (GMS) Scheme — Capitation Agreement — payment to a general practitioner in respect of the registration of asylum seekers
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Asylum seeker/non EU registration fee (a once-off superannuable registration fee)
€179.25
SCHEDULE 11
Services rendered under the General Medical Services (GMS) Scheme — Fee Per Item Agreement — general practitioner consultation fees
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Surgery — day consultation with patient
€12.83
2.
Surgery — late consultation with patient
€18.25
3.
Surgery — night consultation with patient
€36.09
4.
Domiciliary visit — day consultation with patient
€18.93
5.
Domiciliary visit — late consultation with patient
€24.79
6.
Domiciliary visit — night consultation with patient
€48.61
SCHEDULE 12
Services rendered under the General Medical Services (GMS) Scheme — Fee Per Item Agreement — payment for a consultation by a general practitioner at a home for the aged
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Consultation at home for the aged per 3 hour session
€79.11
SCHEDULE 13
Services rendered under the General Medical Services (GMS) Scheme — Fee Per Item Agreement — allowance in respect of a general practitioner whose practice is eligible for a rural practice allowance
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Rural practice allowance (per annum)
€7,613.96
SCHEDULE 14
Services rendered under the General Medical Services (GMS) Scheme — Fee Per Item Agreement — allowance in respect of locum and practice expenses
Reference Number(1)
Description(2)
Amount(3)
1.
Allowance in respect of locum and practice expenses (per annum)
€1,482.23
SCHEDULE 15
Services rendered under the General Medical Services (GMS) Scheme — Fee Per Item Agreement — payments to a general practitioner in respect of special items of service
Reference Number(1)
Description(2)
Amount(3)
1.
Excisions/cryotherapy/diathermy of skin lesions
€24.25
2.
Suturing of cuts and lacerations
€24.25
3.
Draining of hydroceles
€24.25
4.
Treatment and plugging of dental and nasal haemorrhages
€24.25
5.
Recognised vein treatment
€24.25
6.
Electrocardiography (ECG) tests and their interpretation
€24.25
7.
Instruction in the fitting of a diaphragm
€24.25
SCHEDULE 16
Services rendered under the Health (Amendment) Act 1996
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Surgery consultation
€33.00
2.
Domiciliary visit
€43.53
SCHEDULE 17
Services rendered under the Maternity and Infant Care Scheme
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Patient’s first visit
€41.53
2.
Visits 2-8 (per visit)
€29.91
3.
Visit 9
€41.53
4.
Where complete services are provided — patient’s first pregnancy
€262.54
5.
Where complete services are provided — pregnancies other than the patient’s first pregnancy
€292.45
6.
Additional visits by patients with major conditions, e.g. diabetes, hypertension — fee per visit subject to maximum of 5 visits
€29.91
7.
Emergency delivery
€249.22
SCHEDULE 18
Payments to a general practitioner (GP) under the Heartwatch Programme
ReferenceNumber(1)
Description(2)
Amount(3)
1.
Once-off registration fee payable where a GP registers 15 or more patients in the Heartwatch Programme
€1,062.50
2.
Amount payable to a GP for each visit by a patient registered under the Heartwatch Programme up to a maximum of 4 visits by the patient concerned in a year
€42.50
3.
Bonus amount payable to a GP where a patient registered under the Heartwatch Programme makes a fourth visit to the GP under that Programme in a year
€42.50
The Minister for Finance consents to the foregoing Regulations.
GIVEN under my Official Seal,
21 December 2010.
BRIAN LENIHAN,
Minister for Finance.
GIVEN under my Official Seal,
22 December 2010.
MARY HARNEY,
Minister for Health and Children.
EXPLANATORY NOTE
(This note is not part of the Instrument and does not purport to be a legal interpretation.)
These Regulations provide for a reduction in payments to general practitioners in respect of services under the General Medical Services (GMS) Scheme, the Health (Amendment) Act 1996 , the Maternity and Infant Care Scheme and the Heartwatch Programme.

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