Doctors critical of extension of free GP care announced in budget

Budget 2023: IMO says free GP care for 400,000 patients will create hospital-like waiting lists at practices

Budgetary plans to expand the number of people entitled to free GP care will give rise to waiting lists to match those currently plaguing the hospital system, doctors have warned.

Free GP care is being extended to more than 400,000 additional patients, starting with 70,000 six and seven year olds in the last quarter of this year, Minister for Public Expenditure Michael McGrath announced in Budget 2023.

More than half the population will have a medical card or GP visit card when eligibility is extended to those under the median income of €46,000 after tax. The Department of Health says about 430,000 people will be eligible but only 340,000 are expected to apply for a GP visit card.

The department says the measure will be introduced next April and will cost about €111 million a year. GPs are to be provided with €40 million in funding for practice supports to help them implement the change.


The indicative threshold for qualifying for free GP care from next year is €418 a week for a single person or €607 for single parents, couples and families.

Ill-conceived measure

The announcement was sharply criticised by individual GPs and the Irish Medical Organisation, which said it would seriously damage general practice and lead to waiting lists for patients.

It claimed the measure was ill-conceived and poorly planned in the context of current capacity, workload and workforce numbers. As a result, GPs will not be able to cope.

The IMO says it is not opposed to the principle of removing barriers to patients accessing care, but such a large expansion in free care requires “long-term planning, not politically motivated budget announcements”.

It predicts a dramatic increase in pressure on GP surgeries, resulting in the displacement of care of existing patients, including the sickest.

“Giving someone a doctor visit card will not automatically translate into an accessible service when that service is already struggling to cope with current demand,” it said. “This is not good news for patients. Just like the National Health Service in the UK, longer waiting lists will become the reality.”

Free GP care for six and seven year olds was announced in the last budget but is still under negotiation with the IMO.

‘Heart sank’

Tallaght GP Tom O’Dowd said the decision to provide 450,000 people with free care had come “out of the blue”.

“My heart sank when I heard this, and my colleagues feel the same. No warning from our networks, just as we had bedded down free GP care for the under-sixes and after coming through two tough years of Covid.”

Dr O’Dowd said there were over 500 patients on a waiting list to join his practice. It now has patients living all over Ireland, who have been unable to find a new GP after moving.

“General practice is not against providing free at the point-of-use care to patients and families who struggle but we know from the under-six′s research that demand goes up by 25 per cent once it’s free.”

The Irish College of General Practitioners also predicted longer waiting times for patients as a result of the measure.

It pointed to a survey showing that only one in five GP surgeries could take on new medical patients at present, with one in four able to take new private patients.

“All over the country, GP practices have closed their doors to new patients, not because they want to, but because they have reached full capacity and can’t take on any more new patients,” said chairman Dr John Farrell. “This means that people can’t access GP care when they need it.”

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times