The average payment per patient to GPs was €261.53 (€247.66 in 2003) and €692.73 to pharmacists (€595.16 in 2003).
The bulk of the earnings going to GPs are personal taxable income, with much smaller amounts going towards overheads. The highest GP GMS earner is Dr Anthony Crosby, in Raheny, Co Dublin, who received €533,408 in fees last year from the GMS payments board and another €62,171 in overheads.
Unicare Pharmacy in The Plaza, Stillorgan, Co Dublin, was the highest earning pharmacy, taking in €728,365.
Michael O'Connor of Specsavers Options, Cook St, Cork, came out tops among opticians, earning payments of €230,338, while the highest earning dentist was Dr Terence G Fox of Upper Main St, Letterkenny, Co Donegal, who received payments of €306,963.
Fifty-three dentists earned over €120,001. More than 400 earned between €40,000 and €120,000. More than 800 pharmacists earned between €60,000 and €240,000. Four opticians earned more than €120,000 and 1,200 GPs earned between €60,000 and €240,000. Five Dublin GPs were in the top 10 GMS earners and nine of the top 10 earning pharmacies were in Dublin.
Tánaiste and Health Minister Mary Harney said the figures "show that we are paying a substantial amount of money to doctors for GP services". "It is important that we continue to get value for money from the scheme and that it is patient focused, and that is why we want to begin talks on a new contract to modernise primary care services.
"Likewise it is clear that we have a very substantial bill for drugs under the GMS scheme and we must renegotiate the contract with the drug providers to ensure value for money."
During 2004, the GMS payments board (GMSPB) made payments to 5,372 doctors, pharmacists, dentists and opticians for services provided to more than two million people. The total paid provided during 2004 was €1,652.83m, an increase of €221.05m on 2003.
Fees and allowances paid to doctors increased by €21.76m to €317.5m and payments to pharmacies amounted to €1,092.7m, compared with €943.21m in 2003. Dentists received over €52.49m and optometrists €17.44m.
A statement from the Health Service Executive said the increased level of payments "reflects an increasing and ageing population and a resulting growth in the number of people eligible to claim under the various State funded schemes".
Payments for 'hi-tech' medicines such as anti-cancer and anti-rejection drug therapies rose by over €37.83m to €141.41m.