Universal GP care could cost State up to €492m annually

The provision of universal GP care will cost the State up to €500m a year, it has emerged.

A report from the Economic and Social Research Institute (ESRI) looked at three scenarios to assess the potential cost implications.

It finds that universal GP care will add between 2% and 3.5% to overall public healthcare expenditure.

The ESRI says Ireland is unusual in a European context in not providing free or heavily subsidised GP care for the total population.

While medical and GP-visit card holders are entitled to visit a participating family doctor for free, those without a card must pay the full cost.

Under the current system, non-card holders spend between €267m and €355m per year on GP visits.

GPs in Ireland are self-employed and are free to set their fees for private patients.

The Oireachtas committee on the future of healthcare was established in 2016 to produce a single long-term vision for healthcare and the direction of health policy in Ireland.

One of the recommendations of the committee’s Sláintecare Report, published in May 2017, was the introduction of universal GP care — access to GP care for all, without cost.

The first scenario assumes GPs will receive the capitation rates for non-card holders that they currently receive for card holders, plus other fees and allowances.

Using existing capitation rates, the additional annual cost is estimated at €492m.

In scenario two, GPs will seek to secure payment from the State equivalent to the fees they currently receive from private patients.

Such a demand-driven approach will cost between €401m and €489m a year, with visits by former non-card holders increasing by 2.5m.

The third scenario assumes the State will seek to reduce costs by encouraging GPs to delegate more care to practice nurses.

With the skill-mix savings applied, the cost is estimated at between €337m and €418m.

The costs involved in establishing universal GP care are not included in the estimates.

The report does not show the potential impact on spending in other areas, such as pharmaceuticals and hospital care.

Concern about the supply of GPs is raised in the report. Recent estimates suggest there are 64 GPs per 100,000 population, significantly less than the European average of 92 per 100,000.

Financial support for the research was provided by the Department of Health.

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