the European Court of Justice. HSE figures quoted in April 2012 show that at least 178,000 people in Ireland were on waiting lists to see specialists at an outpatient clinic, and that more than 300 patients had been waiting for over four years to be seen by a consultant after being referred by their GP. Health centres Health centres provide a wide range of primary care and community services in towns and villages throughout Ireland, and are run by the HSE. Services available at these clinics include GP services, public health nurses, social work and child protection services, child health services, community welfare, disability services, older people services, chiropody, ophthalmic, speech therapy, addiction counselling and treatment, physiotherapy, occupational therapy, psychiatric services, and Home Help. These services are available for free, or at a subsidised rate. In 2012 a programme of developing 35 primary care centres was announced. By July 2017 only one was operational. 14 are to be constructed by public-private partnerships. General practitioners Primary health care in Ireland is mostly provided by general practitioners (GPs), who generally operate as sole traders or in health centres with other GPs and sometimes nurses. Most GPs also offer house visits to their patients, with emergency "out-of-hours" GP services available in all parts of the country. GPs generally charge on a per-consultation fee basis, usually charging anything up to €65, depending on the region. People with Medical Cards or GP Visit Cards are exempt from charges. About 60% of the population have to pay up-front in cash. Many GPs provide free services to those with hepatitis C and maternity and infant services. Those with private health insurance can, depending on their plan, have their GP costs paid or refunded, either fully or partially, by the insurance company. People can also claim tax relief for GP visit costs. Drugs Prescription drugs and medical appliances are available to all for a small fee (medical card holders), reduced cost (Drugs Payment Scheme) or in certain circumstances free (under the Long Term Illness Scheme) to residents of Ireland. The Drugs Payment Scheme ensures that every household has to pay no more than €124 per calendar month for a month's supply of prescribed medicines and medical appliances, to be cut to €114 from April 2020. Some private health insurance plans provide partial reimbursement up to the Drugs Payment Scheme threshold. Those who are entitled to a medical card