Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank the Senator for raising this important issue. The Government recognises that there are significant challenges facing general practice and that those challenges can limit access to GP services in certain areas and negatively affect the timely provision of care. We all know that is the case. Some issues are specific to certain areas. There is no doubt there has been a general increase in demand for GP services, due in part to demographics and our ageing population.

In recent years, general practice has had to do a lot more. GPs were called on to provide additional services such as Covid referrals and vaccinations. At times, that impinged on routine care delivery. In addition, the services provided by GPs in the community have been expanded, and rightly so, to reduce patients' need for hospital attendance. The chronic disease management programme is now almost fully rolled out and has transformed the management of severe conditions. It is improving the lives of patients.

The Government has taken a number of measures to improve the recruitment and retention of GPs in order to increase the number of GPs practising in the State. It has provided substantial resources to help to strengthen general practice. Since 2019, baseline funding for general practice has been increased by more than €200 million, or approximately 40%, per annum under the 2019 GP agreement. Furthermore, budget 2023 provides additional funding for GPs to recruit extra capacity, with a focus on nursing, administration and IT. The resulting increased capacity will support the planned expansion of GP care without charge for those who earn the median household income of €46,000, or less, from April next year.

The GP agreement provides for significant increases in capitation fees rates for participating GPs, as well as new fees and subsidies for additional services. It also provides for improvements to maternity and paternity leave arrangements and increases to rural practice supports, as well as introducing a support for practices in areas of urban deprivation. These measures increase the attractiveness of general practice as a career choice for doctors. The roll-out of the enhanced community care programme and direct access to diagnostics is of major assistance in the delivery of GP care. More than 200,000 diagnostic scans have been already provided this year and the funding for 2023 has been increased to €45 million, from €35 million this year. Some 30 community specialist teams for older persons and 30 teams for chronic disease management are to be in place by year end. Most of them are now in place and are reducing the need for patients to attend their GP practice.

A sign that the measures undertaken are having the desired impact is that the number of doctors undertaking GP training has more than doubled in recent years, from 120 in 2009 to 258 in 2022. Working with the Irish College of General Practitioners, which now has responsibility for GP training, 350 training places are planned to be available in 2026.

Finally, the Department of Health and the HSE are preparing for a strategic review of general practice to commence shortly. The review, with stakeholder input, will examine the issues facing general practice and set out the measures needed for a sustainable GP service across the country in the long term.