asked the Minister for Health if any information has been made available to his Department to warrant the reopening of discussions with the medical profession on the fee per item of service method of payment to doctors.

6.

asked the Minister for Health if there are any new developments concerning the introduction of the health scheme which is to replace the medical card system; and if he will make a statement on the matter.

7.

asked the Minister for Health the present position concerning the introduction of the proposed general medical health scheme on 1st April next.

I propose, with your permission, a Cheann Comhairle, to take Questions Nos. 5, 6 and 7 together.

I am at present studying a memorandum which I received a few days ago from the Medical Union indicating various matters, apart from the amount of the fees, which general practitioner members of that body would like to see changed as a condition of participation in the proposed reorganised general medical service. The Irish Medical Association has sent me a resolution passed by its council urging that, in view of the deferment of the change in the general medical service, those dispensary doctor posts now filled temporarily should be filled on a permanent basis through the Local Appointments Commissioners.

I hope to arrange an early exploratory discussion with the association and the union to examine these issues.

Further to the Minister's reply, would he not agree that the main items of conflict at the present time relate, firstly, to permanent DMOs and, secondly, to temporary DMOs? Does the Minister think that the resolution calling for temporary posts to be made permanent would be a retrograde step at the present time in view of the fact that we are calling for the abolition of the dispensary system? Would it not be more logical to consider the suggestions which have come from the general practitioners with regard to what they want in the Minister's offer? So far as I know, there are very few differences in the returns about what the profession wants and what the Minister offers.

We cannot have a discussion on the health scheme on these questions.

In view of the fact that the abolition of the dispensary system is such an important matter, would the Minister not think it advisable to reopen discussions with the profession and not to consider at all the making permanent of the MOs? This would be a retrograde step.

For the reasons the Deputy states, I am not taking any steps at the moment to make permanent the positions which are now temporary. There are at least 12 matters for discussion with the IMU and the IMA with regard to what they say caused the members to reject the scheme by a majority. All these things have to be discussed and they will be discussed.

The Minister will agree that these difficulties are not insuperable?

As the Minister is aware of many anomalies in the medical card scheme, will he make every effort to ensure that the new legislation will go through satisfactorily in the best interests of the community at large?

I have been trying to ensure that this new system will operate, but I was unable to gain the consent of the two associations involved.

If it were possible to reopen discussions, could the new scheme come into operation by 1st April?

It could not possibly come into operation by 1st April.