S.I. No. 458/2023 - Public Service Pay and Pensions Act 2017 (Section 42) (Payments to General Practitioners) (Amendment) (No. 2) Regulations 2023


Notice of the making of this Statutory Instrument was published in

“Iris Oifigiúil” of 22nd September, 2023.

I, STEPHEN DONNELLY, Minister for Health, in exercise of the powers conferred on me by section 42 of the Public Service Pay and Pensions Act 2017 (No. 34 of 2017), being satisfied that subsection (6) of that section has been complied with; having complied with subsection (9) of that section; having had regard to the matters specified in paragraphs (a) to (e) of subsection (10) of that section, with the consent of the Minister for Public Expenditure and Reform, hereby make the following regulations:

1. These Regulations may be cited as the Public Service Pay and Pensions Act 2017 (Section 42) (Payments to General Practitioners) (Amendment) (No. 2) Regulations 2023.

2. These Regulations shall be deemed to have come into operation on 1 August 2023.

3. In these regulations –

“Principal Regulations” means the Public Service Pay and Pensions Act 2017 (Section 42) (Payments to General Practitioners) Regulations 2019 ( S.I. No. 692 of 2019 ) (as amended by the Public Service Pay and Pensions Act 2017 (Section 42) (Payments to General Practitioners) (Amendment) Regulations 2020 ( S.I. No. 311 of 2020 ), the Public Service Pay and Pensions Act 2017 (Section 42) (Payments to General Practitioners) (Amendment) (No. 2) Regulations 2020 ( S.I. No. 685 of 2020 ) and the Public Service Pay and Pensions Act 2017 (Section 42) (Payments to General Practitioners) (Amendment) Regulations 2022 ( S.I. No. 23 of 2022 ) and the Public Service Pay and Pensions Act 2017 (Section 42) (Payments to General Practitioners) (Amendment) Regulations 2023 ( S.I. No. 30 of 2023 )).

4. The Principal Regulations are amended –

(1) by the insertion of the following definitions in Regulation 3:

““Agreement of 2023” means the agreement dated 12th July 2023 between the Minister, the Health Service Executive and the Irish Medical Organisation known as the GP Agreement 2023;

“eligible woman” means a medical card or GP visit card holder whose applicable service is not covered by the Health Act 1970 (Section 67E) (Payments in respect of Contraception Services) Regulations 2022, S.I. No. 451/2022.

“relevant products” has the meaning assigned to it pursuant to Section 6 7E (11) of the Health Act 1970 as amended by the Section 6 of the Health (Miscellaneous Provisions) (No. 2) Act 2022 ;”,

(2) by the substitution of “Schedules 10, 21, 37 or 38” for “Schedule 10 or 21” in Regulation 6;

(3) by the substitution of the following schedule for Schedule 2;

“SCHEDULE 2

PART A

Services rendered under the Agreement of 2019 and the Agreement of 2023 – payments in respect of delivery of Chronic Disease Management Programme

Reference Number

(1)

Description

(2)

Amount

(3)

1.

Annual fee payable in respect of an eligible patient (aged 18 years and over) with one of the chronic conditions listed in the Agreement of 2019

€210.00

2.

Annual fee payable in respect of an eligible patient (aged 18 years and over) with two of the chronic conditions listed in the Agreement of 2019

€250.00

3.

Annual fee payable in respect of an eligible patient (aged 18 years and over) with three or more of the chronic conditions listed in the Agreement of 2019

€300.00

PART B

Services rendered under the Agreement of 2019 and Agreement of 2023 – payments in respect of delivery of Modified Chronic Disease Management Programme

Reference Number

(1)

Description

(2)

Amount

(3)

1.

Fee for remote review consultation of an eligible patient (aged 18 years and over) with one of the chronic conditions listed in the Agreement of 2019

€55.00

2.

Fee for remote review consultation of an eligible patient (aged 18 years and over) with two of the chronic conditions listed in the Agreement of 2019

€65.00

3.

Fee for remote review consultation of an eligible patient (aged 18 years and over) with three or more of the chronic conditions listed in the Agreement of 2019

€75.00

PART C

Services rendered under the Agreement of 2019 and the Agreement of 2023 – payments in respect of delivery of Chronic Disease Management Programme

Reference Number

(1)

Description

(2)

Amount

(3)

1.

Opportunistic Case Finding Programme – fee for assessment of a patient (aged 45 years and over) meeting the chronic disease risk criteria as set out in the Agreement of 2019

€60.00

2.

Chronic Disease Prevention Programme – annual fee for assessment of a patient (aged 45 years and over) identified with high-risk of cardiovascular disease or diabetes as set out in the Agreement of 2019 or for assessment of a patient (aged 18 years and over) identified with high-risk of cardiovascular disease or diabetes as set out in the Agreement of 2023

€82.00

PART D

Services rendered under the Agreement of 2019 and the Agreement of 2023 - Practice Nurse Grant

Reference Number

(1)

Description

(2)

Amount

(3)

1.

Practice Nurse Grant per patient registered for the Chronic Disease Management Programme or the Modified Chronic Disease Management Programme

€28.75

2.

Practice Nurse Grant per patient registered for the Chronic Disease Prevention Programme

€14.35

3.

Practice Nurse Grant per patient assessed under the Chronic Disease Opportunistic Case Finding

€3.20

(4) by the insertion of the following schedules after Schedule 34:

“SCHEDULE 35

PART A

Services rendered under the General Medical Services Scheme – Agreement of 2023 – general practitioner capitation rates (all amounts inclusive of former payments towards practice maintenance, equipment and development and former payments in respect of discretionary medical cards)

Reference Number

(1)

Description

(2)

Amount

(3)

1.

Child Patient Aged between 8 and 12 years (inclusive)

€100.00

PART B

Services rendered under the General Medical Services Scheme – Agreement of 2023 – general practitioner capitation rates (all amounts inclusive of former payments towards practice maintenance, equipment and development and former payments in respect of discretionary medical cards)

Reference Number

(1)

Description

(2)

Amount (Total)

(3)

1.

Male patient aged 13 years or more and less than 16 years

€70.71

2.

Male patient aged 16 years or more and less than 45 years

€90.26

3.

Male patient aged 45 years or more and less than 65 years

€180.29

4.

Male patient aged 65 years or more and less than 70 years

€189.92

5.

Patient aged 70 years or more residing in the community

€403.31

6.

Patient aged 70 years or more residing in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks

€644.63

7.

Female patient aged 13 years or more and less than 16 years

€71.52

8.

Female patient aged 16 years or more and less than 45 years

€147.60

9.

Female patient aged 45 years or more and less than 65 years

€198.10

10.

Female patient aged 65 years or more and less than 70 years

€211.87

PART C

Services rendered under the General Medical Services Scheme – Agreement of 2023 – general practitioner capitation rates (all amounts inclusive of former payments towards practice maintenance, equipment and development and former payments in respect of discretionary medical cards)

Reference Number

(1)

Description

(2)

Amount (Total)

(3)

1.

Supplementary out of hours fee for services listed in PART B of this schedule only.

€3.64

SCHEDULE 36

Services rendered under the General Medical Services Scheme – Agreement of 2023 – payments in respect of special items of service

Reference Number

(1)

Description

(2)

Amount

(3)

1.

Excisions/cryotherapy/diathermy of skin lesions

€24.80

2.

Suturing of cuts and lacerations — including application of tissue glue (does not include paper sutures)

€50.00

3.

Draining of hydroceles

€24.80

4.

Treatment and plugging of dental and nasal haemorrhages

€24.80

5.

Cardiovascular investigations, solely for cases of individual patient care and not general screening or routine screening of individuals or both:

(a) Electrocardiography (ECG) tests and interpretation;

€24.80

(b) 24 Hour Ambulatory Blood Pressure Monitoring for diagnosis and treatment of hypertension

€60.00

6.

Removal of adherent foreign bodies from the conjunctival surface of the eye

€24.80

7.

Removal of lodged or impacted foreign bodies from the ear, nose and throat

€24.80

8.

Nebuliser treatment in the case of acute asthmatic attack

€37.21

9.

Bladder catheterization — composite fee for insertion and removal

€60.00

10.

Annual consultation provided to an eligible woman aged less than 45 years for the purposes of obtaining a prescription for accessing relevant products

€55.00

11.

Fitting by a Registered Medical Practitioner of a relevant product that is a Coil for an eligible woman

€160.00

12.

Removal by a Registered Medical Practitioner of a relevant product that is a Coil for an eligible woman

€50.00

13.

Fitting by a Registered Medical Practitioner of a relevant product that is a contraceptive implant for an eligible woman

€100.00

14.

Removal by a Registered Medical Practitioner of a relevant product that is a contraceptive implant for an eligible woman

€110.00

15.

Attendance by general practitioner at HSE-convened case conference

€62.02

16.

GP participation in a Health Service Executive approved Virtual Heart Failure Clinic facilitated by a Consultant Cardiologist – fee per eligible patient with heart failure reviewed at virtual clinic

€100

17.

Provision of therapeutic phlebotomy for eligible patients with haemochromatosis

€100

SCHEDULE 37

Services rendered under the General Medical Services Scheme - Agreement of 2023 - maximum allowances in respect of practice support payable on the basis of a general practitioner’s GMS panel size as determined in accordance with Regulation 6 (all amounts inclusive of the former supplementary grant to general practitioners who employed secretaries or nurses or both)

Reference Number

(1)

Description

(2)

Amount

(3)

1.

Nursing subsidy (per year) - 1 years’ experience

€35,210.25

2.

Nursing subsidy (per year) - 2 years’ experience

€37,284.00

3.

Nursing subsidy (per year) - 3 years’ experience

€39,353.25

4.

Nursing subsidy (per year) - 4 or more years’ experience

€43,725.75

5.

Practice administrator subsidy (per year) - 1 years’ experience

€22,844.25

6.

Practice administrator subsidy (per year) - 2 years’ experience

€24,749.25

7.

Practice administrator subsidy (per year) - 3 or more years’ experience

€26,652.00

8.

Practice manager subsidy (per year)

€41,643.75

9.

Maternity leave subsidy for staff for whom the GP receives a practice support subsidy

75% of reckonable weekly salary minus Statutory Maternity Benefit for 26 weeks

SCHEDULE 38

Services rendered under the General Medical Services Scheme –Agreement of 2023– Additional Capacity Practice Grant, payable on the basis of a general practitioner’s GMS panel size of 500 or more as determined in accordance with Regulation 6

Reference Number

(1)

Description

(2)

Amount

(3)

1.

Maximum grant payable (per year) to qualifying GPs

€15,000.00

2.

Maternity leave subsidy for staff for whom the GP receives the additional capacity practice grant.

Weekly grant amount minus Statutory Maternity Benefit for 26 weeks

The Minister for Public Expenditure and Reform consents to the foregoing Regulations.

Signed by the minister for Public Expenditure and Reform,

13 September, 2023.

PASCHAL DONOHOE,

Minister for Public Expenditure, National Development Plan Delivery and Reform.

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GIVEN under my Official Seal,

18 September, 2023.

STEPHEN DONNELLY,

Minister for Health.

EXPLANATORY NOTE

(This note is not part of the Instrument and does not purport to be a legal interpretation.)

These Regulations give effect to payments in respect of services rendered by a general practitioner to or on behalf of the Health Service Executive under and in accordance with the terms of the GP Agreement 2023.