Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this issue, which is a matter of major concern to the individuals involved. Patient choice of doctor has been, and continues to be, a bedrock principle of the general medical services, GMS scheme. For the vast majority of individuals, their choice of doctor is accommodated and they are registered on the GMS panel of their doctor of choice. In 2022, which was the last full year of data available, out of a total of about 348,000 individuals who were approved for either a GP visit card or a medical card, 3,927 individuals were unable to secure placement with their doctor of choice, or 1.1% of the total. In addition, 3,701 existing GMS patients were reassigned following a change in their place of residence.

While recognising the difficulties this can pose for individual patients, it is fair to say that the extent of the challenge is relatively small in the overall scale of the GMS service provision. However, I acknowledge and accept that for that small amount of people who are finding it difficult, it is very challenging. For those individuals who are unable to locate a GP, a long-standing process is in place in line with the contractual arrangements, whereby individuals are enabled to access GMS services from alternative GPs, either by agreement with individual doctors or through the patient assignment process. In line with these arrangements the HSE may assign an eligible person to be included on a medical practitioner's GMS list.

It is important to confirm that this process whereby the HSE can, under the provisions of the contract, assign patients to GPs remains in place. However, in the period between 1 July to date - this is what Deputy Daly is referring to, that is July, August and September - the HSE was obliged to exercise caution around the application of assignments, dealing principally with urgent and priority cases in advance of the new arrangements that are now being implemented following the agreement with the Irish Medical Organisation, IMO reached last June.

In the context of the learnings from the operation of the existing arrangements, and having regard to the implementation of the extension of eligibility of GP visit cards to include under-8s and those on no more than the median income, it was agreed with the IMO as part of the GP agreement for 2023 to flex the existing arrangements with a view to ensuring an equitable and fair distribution of patient assignments to individual GPs and across geographies, for example, not putting 30 with one and one with another.

In addition to the foregoing, a joint HSE and IMO working group is being established to review the operation of the patient assignment protocol to ensure that it is framed and operating in a fair, equitable, patient- and GP-centred manner and that due regard is given to health and safety considerations regarding GP practice teams, as well as impact on patients in terms of how it is being operationalised.

In response, there has been an issue in the last three months but now it is being resolved in such a way that it is fair and equitable for patients. It will be interesting to see how it will work out going forward. I am aware of some of these cases as well, which came through my own constituency office and I know exactly what the Deputy is talking about regarding people who might have relocated from another country.

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