Single GP practices should be scrapped and replaced by larger co-operatives offering extra services, the Labour Party has recommended.
Proposing major investment in primary care, Labour said GPs should be able to refer patients for hospital tests without having to send them through A&E.
The GP co-operatives should work longer hours and offer out-of-hours emergency care, which is not available in many places currently - particularly Dublin city's northside.
Doctors should receive grants to set up practices in poor and remote areas, though they should also have to meet strict standards of care, the party declared.
Labour's document, Healthcare - A New Direction, was presented yesterday by party leader Pat Rabbitte, deputy leader Liz McManus and Dublin South general election candidate Aidan Culhane.
"There are no quick fix solutions, and Labour will not make easy promises," Mr Rabbitte said.
The party has set five aims: "to build more beds; get the simple things right; keep care local where you can; keep our hospitals not-for-profit; and tackle waste by ensuring that money follows the patient."
Ms McManus, Labour's health spokeswoman, said the party's promises would be implemented over the lifetime of a government. "It would be foolish for us to say that we will do this, or that in six months, or 12 months."
Medical cards should be held by 40 per cent of the population, rather than the 28 per cent at present - though the awarding of the extra cards should be means-tested. The plan would benefit 500,000 at an annual cost of €400 million.
The Government's decision to grant cards to all over-70s cost more than expected, and has distorted the spread of GPs, since many of them have been encouraged to set up in wealthier areas because they get paid four times more to look after over-70s than they do to care for other medical card patients.
Mr Rabbitte acknowledged that the concession to the over-70s could not be withdrawn now: "That wouldn't be feasible, even though it has created serious disparities."
Local authorities should build primary care centres backed by a paramedical and ambulance service to offer immediate treatment for relatively minor illnesses and injuries.
"Patients with sprains and cuts should be treated locally. In this way, scarce A&E resources can be directed to those with more critical conditions," said Cllr Culhane.
Warning that one-third of the State's 2,400 GPs will retire in the next 10 or 15 years, Labour said more GPs should be trained urgently, while doctors aged over 65 should be encouraged to stay at their posts.
