Health spending: Extension to GP card would put ‘huge pressure’ on primary care system

The Irish Medical Organisation (IMO) has strongly criticised the Government’s budget measure to expand the GP visit card to 430,000 in Budget 2023.

The IMO has described the initiative as “ill conceived, and poorly planned” in the context of current capacity, workload and workforce numbers.

The IMO warned that GPs will “not be able to cope with the consequences of this proposal”.

The IMO said “while we support the objective of removing financial barriers to patients accessing care, such a significant expansion in patient numbers (over 25%) requires long term planning, not politically motivated budget announcements.”

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The IMO believes that this announcement, if implemented, will lead to a dramatic increase in pressures on GP surgeries as demand for appointments will inevitably increase and current levels of care will be displaced.

Earlier on Tuesday morning Killarney GP Dr Gary Stack said the proposal will ultimately affect patients who need care and that there was not sufficient GP numbers to service the level of care that is required.

“It’s going to result in delays in care, it’s going to result in delayed investigation and treatment in hospital. I think the legacy of this Minister will be a legacy of GP waiting lists which didn’t exist prior to his entry here,” he told RTÉ Radio’s Morning Ireland.

“This to me is a political sop, there’s no medical benefit in doing this — we already have huge waiting lists in secondary care, we don’t want to bring those waiting lists into primary care, we want to provide the best care we can, but if they are doubling the visiting rate — that cannot be coped with in general practice in-hours or out-of-hours.”

In the United Kingdom, efforts were being made to reduce GP waiting lists while the situation appeared to be going in the opposite direction in Ireland, he added. “There will be no extra access to primary care services, just a free visit to a GP, a saving of around €50 on average.”

The free visit card would put “huge pressure” on the primary care system, particularly the out-of-hours service as many patients do not have a GP.

“We see lots of patients who don’t have a GP, and that falls into out-of-hours putting huge pressure on out-of-hours and the service we’re trying to provide when really they need a GP for continuing care and follow up,” Dr Stack said.

“I don’t think any GPs were expecting (it) ... 430,000 divided between 3,000 GPs is almost 150 extra GP visit cards per patient.

“We were told during Covid to follow the science — the science of this basically is anybody with free access there will be a doubling of visits to GPs per year so it will go from three to six, that’s an extra three visits per GP, that’s 450 visits in the year, or nine each week, an extra two-and-a-quarter hours plus 50 per cent on top of that for paperwork, so that’s an extra three to three-and-a-half hours work per week. But there aren’t GPs there to fulfil that,” Dr Stack said.

The concerns of GPs were not in relation to the contract for medical cards — it was a manpower issue, he added.