Report urges health system changes to benefit patients

DRASTIC health system changes to prevent existing GPs from blocking new doctors working in their area are set significantly to improve patients’ access to primary care services.

A new report from the Competition Authority has ruled that the existing General Medical Services (GMS) contract system must be overhauled in order to free-up space for new GPs.

Under the existing system, GMS contract GPs are paid an annual capitation fee by the State per patient, with the costs depending on the type of service provided and the distance a doctor needs to travel to see the individual.

In addition, a GP who acquires a GMS contract must stay in a defined region and work in a practice that has been in operation for at least five years.

While the current system is considered to be valuable to existing GPs, the Competition Authority has warned that it is effectively preventing new doctors from opening clinics and, as a result, improving service access for patients.

The independent body said this situation “limits the number of GP practices in Ireland” and is leading to large amounts of money being paid out to the primary care system that can be better spent elsewhere in the health service.

As a result, it has concluded that a series of changes should take place to improve access to patient care.

The changes include:

GPs in possession of a GMS contract should be allowed to work in, or move to, the location of their choice.

Decisions to award a GMS contract in a particular area should not take into account the impact this could have on doctors already working in the region.

The interview system for awarding a GMS contract should not automatically favour a GP already in possession of such a contact.

GMS payments to GPs in future should not be decided on agreement with medical unions

Under the existing system, which reduces competition in the primary care service, some GPs have received annual payments of up to €1 million.

However, despite the financial incentive currently in place, the IMO has broadly welcomed the proposed changes. with its vice-president and GP chairman, Dr Ronan Boland, stating that the move will help to improve patient services.

“There is a shortage of trained GPs in Ireland at present which will worsen in the short term at least.

“This shortage is reflected in most other EU states,” he said.

The Competition Authority verdict came as an independent group of experts recommended significant reform of the GP system, including a visit costs ceiling of €40 being introduced across the country. The proposed system, involving the use of primary care cards, would see patients paying a small capitation cost to their GP along with a fee per visit depending on needs.

The group behind the proposal is made up of economists and health care professionals, which was asked by Health Minister Mary Harney to look at how resources are allocated and financed.


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