David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I welcome all of our witnesses and genuinely thank them for their comprehensive opening statements and the impressive supporting information presented to us. I am grateful for that. It helps us as a committee when we get that level of detail.

I will first make a number of broad points before I put my questions. I was one of those who asked to have this session to put a focus on GP capacity. In recent times, we have had some anecdotal evidence from constituents and others about waiting longer for GP access and difficulties in accessing out-of-hours services. Some people are unable to find a GP with whom to register. This applies not just in rural areas but also in Dublin. Obviously, there are capacity issues and these are very well set out in the opening statements.

We need to increase GP capacity. I will get to this in my questions. We also need to look at how we better support GPs when they qualify and want to establish practices. There are issues in those areas, as has been highlighted, and also in expanding GP teams.

I will start with the data and facts. The IMO and ICGP are pretty much on the same page with the figures. We have some 3,500 GPs. We have 30% fewer GPs per head of population than in England. The Department recognises that we need an increase in GP numbers of between 37% and 48%, and that we need to train more GPs. To take the calculations, according to the IMO opening statement, some 20% of current GPs will retire in the next five years. This means 700 of the current cohort of 3,500 will retire and must be replaced. We also need to hire between 1,260 and 1,660 additional GPs. Taking the midpoint of 1,500 additional GPs and add the 700 who will retire, it means 2,200 additional GPs will have to come into the system by 2028. By my calculation, that is 366 new GPs every year which is much more than the numbers we are training every year. We can see the problem here and, to be honest, it is because for the past ten years, we have not done what needs to be done in increasing capacity.

Are the current figures on the need for additional capacity and additional GPs based on a no-change policy? In other words, are they based on existing levels of service? As we all know, there is an all-party agreement to transition to universal GP care which will, I imagine, place additional demands on the system. We must look at the demographics and what that additional demand would look like. When we say somewhere between 1,200 and 1,600 additional GPs are required, is this built on a no-change policy or does this build into it the move towards universal GP access?