Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Senator Conway for raising this issue as GP out-of-hour co-operatives are essential to the delivery of primary care health services. I thank the Senator for continuing to raise health issues in his own area in a constructive way.

As he will be aware, GPs are required under the General Medical Services scheme to make suitable arrangements to enable contact to be made with them, or a locum or deputy, for emergencies outside of normal practice hours. Most GPs meet this obligation through GP out-of-hours co-operatives that facilitate the provision of GP services outside of normal surgery hours.

Shannondoc out-of-hours co-operative provides urgent GP services to patients in the mid-west region, including Limerick, north Tipperary and Clare. While GP out-of-hours co-operatives are private entities, the HSE provides substantial funding to support co-operatives through service level agreements covering a wide range of costs. Last year, the HSE provided over €5 million in funding for Shannondoc GP out-of-hours co-operative.

The HSE maintains regular contact with the co-operatives to help optimise out-of-hour service levels. Even greater engagement was undertaken to ensure that the services continued to provide the supports needed by local communities during the Covid pandemic. Since the emergence of the Covid-19 virus, the HSE provided out-of-hours co-operatives with a support grant to ensure continuity of care. Funding for Shannondoc was increased to over €6.8 million in 2020, including increased funding due to the pandemic.

Where there is increased demand in certain areas, Shannondoc can provide support from other treatment centres, to ensure services are provided where needed most. The service is demand led, and the HSE has advised that Shannondoc has continued to meet the targets for urgent and routine calls set out under its service level agreement. More generally, the Government is committed to increasing the number of GPs working nationwide and therefore improving access to GP and GP out-of-hours services across the country.

Under the 2019 agreement, investment in general practice is to increase by 40% between 2019 and 2023. Expenditure has already been increased to date by €206.6 million annually, increasing to €211.6 million per annum next year when the agreement is fully rolled out. This provides for significant increases in capitation fees for participating GPs, as well as new fees and subsidies for additional services.

The agreement also provides for improvements to maternity and paternity leave arrangements, introduces a €2 million support fund for GPs in areas of urban deprivation and increases the existing support funding for rural GP practices. The increased investment provided will increase the number of GPs working in the State and will help sustain general practice nationwide, both GP practices and out-of-hour services. The positive impact of the measures undertaken by the Government is evident from the increasing numbers of entrants to GP training, from 120 in 2009 to 233 trainees enrolled last year and 258 places will be made available this year. That is something I know everyone will welcome. The 2019 GP agreement includes a commitment to undertake a strategic review of GP services to examine how best to ensure the sustainable provision of those services into the future. The sustainability of services is what we all want. The review will encompass a broad range of issues, including examining how best to provide for GP out-of-hours care, and will include consultations with relevant key stakeholders. The Department of Health is engaged in the preparatory work for the review which, once completed, will inform future contractual changes. I am sure the Senator will agree that over the past two years, between Covid and the cyberattack, a lot of time was lost. This review is very important and is a commitment under the 2019 agreement with GPs.