'Free GP care for all plan requires road-map and more doctors'

Other changes to 'overhaul' the system include training more GPs and funding care in deprived areas.

The expansion of free GP care to all first requires a road-map and more GPs in place, otherwise it will “waterlog” the system, a leading GP has claimed.

Dr Tadhg Crowley, Irish Medical Organisation GP committee chair, was responding to calls for action on a decade-old Government plan.

A Social Democrats motion in the Dáil on Wednesday called for free care to reach under-12s this year and everyone by 2030. 

Other changes to “overhaul” the system include training more GPs and funding care in deprived areas.

Dr Tadhg Crowley, Irish Medical Organisation GP committee chair, pointed out 42% of people pay for appointments because they do not have a medical or GP visit card. Picture: Shane O'Neill

“It’s a list of aspirational things you would like to have in a good health service and a primary health service,” Dr Crowley said.

Ireland is absolutely an outlier in terms of the rest of Europe in not providing free GP care.

He pointed out 42% of people pay for appointments because they do not have a medical or GP visit card.

“You are going to need more GPs,” he said, adding that expanding nurse roles is welcome but should not be the only step.

“If we expand free GP care in the next year, you will waterlog the system in terms of people will not be able to access the service and end up in hospital which is not what you want,” he said.

He added: “I think you have to say you need a road-map and, along that, you need certain absolute sign-posts you have to reach before you get onto the next stage.” 

The motion also included pressures on out-of-hours services such as Southdoc and Caredoc.

Dr Crowley agreed, saying: “It’s quite different now [to when this was set up] because it’s full on. 

“You’ve come off your normal day-to-day surgery and you’re now working in what I’d call a more litigious environment. 

The motion also included pressures on out-of-hours services such as Southdoc and Caredoc.

"You don’t know the patients and you’re under pressure to see the number of patients that need to be seen.” 

He called for more supports for new GPs, saying larger practices allow GPs to share support staff and reduce costs.

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“One of the Social Democrats' solutions is to have paid GPs [working for the HSE] and I don’t think the research model supports that,” he said.

Concerns about being responsible for a practice linked to health cuts after the 2008 recession have eased since an agreement between the IMO and the Government on payments, he said. 

The State would get “more bang for its buck” supporting young doctors to set up large practices or existing small practices to merge, he argued.

Social Democrats health spokesperson Pádraig Rice said after the debate: “While the Government did not oppose our motion, neither did they commit to implementing our plan to reduce costs for patients and expand access to GP services.

“We’re still being told that we have to wait until the Strategic Review of General Practice is completed, something that was promised seven years ago but is still ongoing.”