Brennan Report - Department of Health and Children

Report of the Commission on Financial Management and Control Systems in the Health ServiceCHAPTER 6ACCOUNTABILITY – GENERAL MEDICAL SERVICESAND COMMUNITY DRUG SCHEMESIn this Chapter, we examine the accountability issues to be addressed in the General Medical Services (GMS)and the Community Drugs Schemes, particularly the Drugs Payment Scheme.6.1 OVERVIEWPrimary care contractors are a crucial part of the health service infrastructure. In manyinstances, the General Practitioner (GP) and pharmacist link the service user to the healthsystem. A modern, effective health service requires quality standards and value for money in allaspects of primary care.The cost of the GMS has increased rapidly in recent years. In our view, action is required on anumber of fronts. Accountability issues that must be addressed include the services requiredand provided by GPs within the GMS and the publicly funded drugs and medicines schemes asthey currently operate.We believe there is significant room for improvement. The increases in expenditure on theGMS, discussed in Chapter 2, are further examined in this Chapter. The figures make acompelling case for reform.6.2 GENERAL MEDICAL SERVICES (PAYMENTS) BOARDThe function of the General Medical Services (Payments) Board is to make payments due undermedical cards, drug subsidisation, long-term illness and dental treatment service schemes as wellas a range of community-based services. It is the role of the Board to calculate, verify and makepayments under the various schemes and to compile statistical information.The greatest costs covered by the GMS (Payments) Board arise in respect of the medical cardscheme and the Drugs Payment Scheme (Table 6.1). Of the population, 31% are covered bymedical cards and the balance of 69% are eligible for the Drugs Payment Scheme.76