Paul Connaughton (Galway East, Fine Gael)

Was that what Deputy Murphy was saying?

I am pleased to have the opportunity to address the House on this important Bill which will allow suitably qualified GPs to treat private patients along with patients holding full medical cards and doctor visit cards. There are many positive aspects to the Bill. It encourages competition and, hopefully, it will drive down the cost of a GP visit for families. It will facilitate newly-qualified GPs to stay in Ireland and it will hopefully allow many GPs to establish practices in the regional towns throughout the country.

It is a sad reflection on the previous Government that such legislation has only come about following prompting through the EU-IMF programme of commitments to remove restrictions to sheltered sectors and I commend the Minister on the speed with which this legislation is being enacted and the fact that this is another pre-election promise delivered upon.

In the past, younger, properly qualified GPs were unable to set up GP practices because of the rules which restricted GPs wishing to treat public patients. That situation prevented many young, highly-qualified and highly-trained GPs from obtaining a GMS contract early in their careers and many opted to work abroad as a result. Those who did set up business were restricted to private practise and given the downturn in the economy in recent years, many of their patients found themselves to be eligible for medical cards and could not continue to be treated by their family doctor of many years. When the Bill is enacted, new GMS contract holders will be free to establish their practice in the location of their choice and existing contract holders will also have the opportunity to move with the prior approval of the HSE.

GPs are a vital cog in the wheel of the health service. Without enough GPs, more pressure will be brought to bear on emergency departments, many of which are already under significant pressure with an increase in the volume of patients. Increased pressure in emergency departments puts pressure on the entire hospital service.

One major benefit of the Bill is that it removes the barriers in place previously in terms of setting up a general practice. The number of GPs holding GMS contracts has been rising steadily but there are currently approximately 2,800 registered GPs practising in Ireland, a low ratio compared to our European counterparts. Ireland will face a severe manpower shortage in general practitioners in the near future. Up to one third of GPs are expected to retire in the next ten years and survey results show that by 2020 almost 30% of female GPs and 5% of male GPs will be working part-time. Steps have been taken to address this problem, including a doubling of the intake of medical students and an increase the number of GP training places from 120 to 157.

One major aspect of the Bill is the fact that it creates competition among GPs and this should benefit many hard-pressed families throughout Ireland. One quarter of the population have no health care cover, either through medical card or private insurance and one half of this number have made no GP visits in the past year. Costs are keeping many people away from their GP. In addition, many families are excluded from the medical card system because the assessment of self-employed people may relate to years when their income was a good deal higher than it is at present.

Despite the recession, there has been little downward movement in terms of prices charged by GPs. A fee of €45 appears to be at the lower end of the scale, with some city practices charging €70 per visit. This is the case at a time when OECD statistics indicate that GPs here are paid more than their counterparts in the United Kingdom, Germany, France or Sweden. Since 1 June dentists have been obliged to display prices for their services publicly. This requirement should be extended to GPs. The obligation to display prices, along with dental tourism, has seen significant reductions in the prices charged for dental consultations. A survey by the National Consumer Agency last year showed that 50% of GPs display their prices. While price is not the only consideration when it comes to choosing a GP, in these times it is an important consideration for many families. People should consider visiting sites such as whatclinic.com, a database of doctors, including prices where available.

The Bill is to be welcomed. It will give medical card and GP visit card patients a wider choice of GPs. It will encourage young GPs to remain in Ireland and it will encourage much-needed competition among our doctors.

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