Maria Byrne (Fine Gael)
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I thank the Minister of State for coming to the House to discuss this important issue. What will the Department do to alleviate the pressure general practitioners, GPs, are under, but also to improve the delivery they are able to provide? In Limerick, which is my area, many people cannot get a GP appointment. They are waiting three or four days for an appointment. I recently met a person who had to wait two weeks for an appointment. In addition, many people cannot get on GP lists. GPs are under enormous pressure. The population is growing, especially in Limerick, and there are not enough doctors to facilitate people who want to get on a GP list.

On the other hand, University Hospital Limerick is in the newspapers every day in the context of overcrowding. Part of the reason for that overcrowding is that people are presenting at the hospital because they cannot get an appointment with their GP. I ask the Minister of State, on behalf of the Government, to lay out the resources that will be given to doctors to help to alleviate waiting lists.

People deserve to get good medical care. It is not the fault of doctors that their waiting lists are so long; it is just that there are not enough doctors. People become ill at different stages and they deserve to receive good care. I look forward to hearing the response of the Minister of State.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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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.

Maria Byrne (Fine Gael)
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I thank the Minister of State for his comprehensive response. He indicated that the number of GP training places will increase by 2026. We have a problem in the short term, however. He referred to enhancements that are happening in rural areas. During Covid, there were a number of mobile units. Doctors held clinics in villages one or two days a week. Many of those clinics have not reopened. That is something the Minister of State might be able to consider. The local doctor in Cappamore used to attend at the dispensary in the village of Moroe, County Limerick, once a week. Many people in the area do not have a car and were finding it difficult to get to a GP. That is one of the many issues.

In addition, I would like the Minister of State to consider how we can incentives some of the doctors who are working abroad to come back here to work. That would help to ensure people do not have to wait days or weeks for a GP appointment.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Senator. I hear what she is saying in respect of practices closing down after Covid. Many things have changed. However, general practice is providing more to the community and, although demand for services has increased, steps have been taken to increase GP capacity and support general practice and those steps are having a positive impact. The increased investment in general practice, with improved fees and supports, is attracting more doctors into general practice. As I stated, the number of doctors training to work as GPs has increased in recent years. The establishment of community-based specialist teams will ease the demand for GP services from older persons and those with chronic diseases. The swift provision of scans through the direct access to diagnostics programme eases the burden on GPs to manage patients awaiting testing. The Senator and I would agree that more work needs to be done to improve GP services further and to cater for increasing demand as the population continues to increase and age and more people are provided with GP care without charges.

The planned strategic review will examine a comprehensive range of issues. It will identify changes and the need for a better GP service into the future.