Nicky McFadden (Longford-Westmeath, Fine Gael)

I welcome the opportunity to speak on this Bill today and thank the Minister for introducing it to Dáil Éireann.

As of the beginning of October, 1,701,951 people in Ireland have medical cards. A further 128,292 people are entitled to a GP visit card. The Irish Examiner revealed recently that 214,165 more people became eligible for medical and GP visit-only cards across the country between January 2010 and May 2011. This means 39% of the population is now entitled to State-funded financial health support, up from 34% at the start of 2010.

There are anecdotal suggestions that GP visits have fallen between 15% and 30% in recent years. This, sadly, does not mean that people are suddenly getting healthier and fewer people require GP services. In reality, it is a stark reminder that for many people financial concerns take precedence over getting better. It is simple but true. Access to health care should be based on health need, not income. People should not have to make a choice between going to a GP and having enough money to get through the rest of the week. I commend the Minister on introducing universal health care.

The GMS scheme currently provides free GP visits to public patients throughout the State and covers one third of the population. When the GMS scheme was introduced, public patients were treated alongside private patients and could only choose a GP from among those registered with the scheme. This resulted in a limited pool of GPs available for public patients. Medical card and GP visit card holders should not have to face this restriction in choosing a GP. This legislation removes the current restrictions, allowing public patients greater freedom in choosing which GP they wish to see. Opening the sector to competition will offer a far better choice and better prices for patients.

While the Bill serves to implement an undertaking in the memorandum of understanding with the troika, its provisions are timely and much needed in any case. In other words, the IMF demand for greater competition in so-called sheltered sectors, such as GP services, is a welcome requirement. As it stands, patients can expect to pay anything between €45 and €70 for a quick GP visit. Increased competition among medical practitioners, as provided for in the Bill, will mean medical card and GP visit card holders will have a greater choice of GPs. Any doctor who wishes to obtain a GMS contract will be free to do so. This will encourage young GPs to remain in the country and perhaps encourage some who have left to return.

These changes are in line with the Competition Authority's July 2010 report on GMS practitioners, which recommended that access to GMS contracts be opened up to all qualified GPs. The report noted that decisions to award the GMS contract in an area should not have to take account of the viability of GP practices already operating in an area. GPs in possession of GMS contracts should be free to set up in, or move to, a location of their choice. While only a small section of GPs has benefited from the GMS contract in its current form, we should bear in mind that much of the money is spent on overall upkeep of GP practice and on hiring staff. This change in legislation should not demonise GPs currently operating the scheme. Moreover, the amount of money allocated to GPs under the GMS contract has been decreased. This may have a negative effect on GPs who operate in disadvantaged areas and thus have a greater dependence on public patients.

The arrival of new GP practices will benefit patients in the form of greater choice and reduced charges. This will give young GPs the opportunity to set up wherever they wish. Newly qualified GPs deserve the opportunity to set up practice in Ireland at a time when there has never been a greater need for their services. There are currently some 2,800 registered GPs practising in Ireland, representing a ratio of 0.6 GPs per 1,000 population. Recent reports from FÁS and the ESRI make clear that Ireland is facing a manpower shortage in general practice in the near future. This Bill will afford medical card and GP visit card patients a greater choice, ensure that any suitably qualified doctor who wishes to obtain a GMS contract will be free to do so, and encourage young GPs to remain in Ireland. It will have a positive outcome for both patients and GPs.

I thank the Minister for bringing forward this legislation. I commend him on his work in this and other areas, including the roll-out of the primary care strategy.

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