asked the Minister for Health if, as promised in the Joint Programme for Government, he has had any negotiations with medical interests with a view to changing the fee-per-item system of payment under the General Medical Service; and if he will make a statement on the matter.

The report of a working party comprising representatives of my Department, the health boards and the medical profession reviewed the operations of the General Medical Service including the method of paying doctors and was published in August 1984. That report concluded that a change in the method of payment would be desirable and that a modified fee-per-item system would be most likely to be successful in meeting the relevant criteria for a method of payment, including those of my Department. Negotiations with the Irish Medical Organisation arising from publication of that report commenced in December 1984 and are continuing. I am hopeful that these discussions will result in a new method of payment which will satisfy the objectives implicit in the relevant section of the Joint Programme for Government.

Can I take it from the reply that the proposal to replace the fee-per-item with a capitation system has been abandoned?

No decision or outcome of the negotiations is available as yet. There is not in existence anywhere in the world a capitation system, although many persons talking about such services talk about a capitation system. For example, in the United Kingdom there is a capitation system with a modified fee per item for a particular service. We will have the negotiations completed as quickly as possible, but I have not abandoned any position as yet. I am still in a negotiation position but I have very definite views about the merits of a capitation system.

The remaining questions will remain on the Order Paper for the first sitting day after Easter recess.