‘There’s only a certain number of patients you can see in a day’ - Doctors explain concerns around free GP care

The Government plans to provide free GP care to an additional 500,000 people shortly - 78,000 children aged 6 and 7 and 430,000 people in households earning up to €46,000 (the median income). However, GPs are deeply unhappy with the proposal and its introduction has been delayed. We asked delegates at the Irish Medical Organisation what their concerns are.

Dr Ray Walley, Dublin

“We have a shortage of general practitioners in the system. There’s only a certain number of patients you can see in a day. When you are given a medical card - it’s actually a doctor-only card - you increase your attendance. Previously a fee may have reduced the likelihood of attendance.

“With no fee, attendance increases three or fourfold; the difficulty is that we do not have the capacity in the system. We have significant concerns that this is going to displace people who may urgently need to be seen. Often that will be older patients.”

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Dr Aideen Brides, Monaghan

“The figure of 500,000 GP visit cards sounds good. If somebody’s going to get one, of course you’d think it’s a positive step. However, in general practice at the moment, we’re working well. We’re one of the few aspects of the health system that is able to provide same-day or at least next-day access. If somebody is sick or needs to be seen, they will get an appointment. That’s not going to happen if you give out half a million GP visit cards.

“We know that those people will attend two to three times more frequently during the year. But we have no GPs - the GPs we have are retiring and there is just not going to be the access to emergency care that is needed.

“A doctor visit card sounds fantastic but it only accesses the GP. It doesn’t increase access to physiotherapists, psychologists, hospital doctors or radiology. Without funding a proper free-for-all health service there’s no point in giving more doctor visit cards.”

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Dr Tadhg Crowley, Kilkenny

“We have a capacity issue in relation to general practice. Looking at the numbers, people with a card tend to attend the doctor more often. The patient thinks they have a card to attend the GP but now they have limited access. They’re not actually getting what they think they’ll get.

“In relation to people who really need the card and already have it, they’re getting less access to healthcare.

“We have a crisis in terms of recruitment and GPs retiring. Everyone is agreed we probably need another 1,200 GPs to come into the system. We are increasing the number of GPs training. But at a moment when we’re just coming out of Covid, when we have a crisis of obesity and chronic disease and a recruitment crisis, this is going to become an issue and the Minister (for Health Stephen Donnelly) is trying to run ahead very quickly on it.”

Dr Austin Byrne, Tramore, Co Waterford

“The main reservation we have is that we know from previous rollouts of doctor visit cards in other age cohorts is they do generate additional footfall. This is quite reasonable as people who obtain a doctor visit card will rationally seek to use it to access services.

“Unfortunately, services are currently at capacity. When we move to a position of placing more strain on an existing service, what gives way is access.

“While people will have an additional entitlement to service and use it appropriately, our fear is the displacement of those most at need and the creation of unnecessary delays in general practice. It will become incrementally harder to see a GP for the things that people need to seek help for. So while people are being given a benefit that’s tangible on one hand, they’re also being excluded from the service on the other.”