Tuesday, 16 June 1998
Dáil Éireann Debate
222. Mr. Shatter asked the Minister for Health and Children the number of general practitioners, if any, in respect of whom he has received complaints regarding the methadone treatment programme, to the effect that the general practitioner is prescribing methadone to more patients than the recommended numbers; the nature of the complaints received; the dates on which they were received; the action, if any, taken to date by his Department in this regard; whether it is his intention to furnish these complaints to the Medical Council; and if he will request that the council conduct investigations as it deems appropriate. [14278/98]
Minister for Health and Children (Mr. Cowen): My Department investigates complaints about the prescribing of controlled drugs by general practitioners in the context of the Misuse of Drugs Act, 1977. Arising from these investigations I have the power to set up a special committee of inquiry in individual cases to investigate each case in greater detail, after which inquiry I may issue a special direction prohibiting that general practitioner from prescribing certain controlled drugs. Under the Act there is also provision for the findings of such inquiries to be relayed to the Medical Council so that it may take whatever further action it considers necessary in relation to the general practitioner. The Misuse of Drugs Act, 1977 does not provide for a limit on the number of patients for whom an individual general practitioner can prescribe. The question of taking action in relation to patient numbers does not therefore arise.
The report of the expert group on the establishment of a protocol for the prescribing of methadone sets out recommendations for the involvement of general practitioners and community pharmacists in methadone maintenance programmes. It recommended that general practitioners should become involved by taking on responsibility for the care of opiate dependent persons who had first been stabilised at community drug treatment centres. It also outlined the criteria necessary to ensure that methadone prescribing occurred in a controlled, responsible fashion. Many elements of the protocol have been implemented. Most notably, a central treatment list of patients being prescribed methadone has been established. Under this arrangement a general practitioner who is considering prescribing methadone for a patient can check whether the patient's name is on this treatment list and so minimise the possibility that the patient concerned is receiving methadone from more than one source. However, it was only in the report of the review group of methadone treatment services, which was published in January 1998 that recommendations were made regarding limits on the number of patients that a general practitioner should treat. The Irish College of General Practitioners is represented on the methadone protocol implementation committee which is overseeing the implementation of the report's recommendations and the college, together with the Eastern Health Board and my officials, is working closely with general practitioners who  prescribe to high numbers of patients, so that they can comply with the recommendations regarding numbers. My officials have also had discussions with the Medical Council about actions being taken in relation to methadone prescribing.
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