Stephen Donnelly (Wicklow, Fianna Fail)
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129. To ask the Minister for Health his views on whether the general practitioner sector is facing a recruitment and retention crisis; his further views on whether the refusal to reverse FEMPI measures for general practitioners is a major driver of the crisis; and if he will make a statement on the matter. [43553/18]

Simon Harris (Wicklow, Fine Gael)
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General Practitioners play an important role in the primary care system. The number of GPs on the specialist register continues to increase – up from 2,270 in 2010 to 3,669 as at July 2018. The number of GPs holding GMS contracts has also risen from 2,098 in 2008 to 2,507 as at 1 September 2018.

The Government is aware of workforce issues facing general practice, including the influence of demographic factors, and has implemented a number of measures to improve recruitment and retention in general practice.

GP training places have been increased from 120 in 2009 to 193 places filled in 2018, an increase of around 60% over a nine year period. The Government's objective is to continue to achieve annual increases in the number of training places available while ensuring that all of the places are filled.

Entry provisions to the GMS scheme have been changed to accommodate more flexible GMS contracts and the retirement age for GPs has been extended to 72. An enhanced support package for rural practices has been introduced with improved qualifying criteria and an increased financial allowance of €20,000 per annum.

Officials from my Department and the HSE recently re-engaged with the Irish Medical Organisation to set out the State's position in relation to reform of the GMS contract. Agreement on the delivery of service improvements and contractual reform has the potential to facilitate a substantial increase in the resourcing of general practice on a multiannual basis.

Under the General Medical Services (GMS) contract, GPs are reimbursed for a range of services they provide to medical card and GP visit card holders. GPs are remunerated for these services primarily on a capitation basis, with a range of additional support payments and fees for specific items of service. GPs are also remunerated for services they provide on behalf of the HSE under other public health schemes, such as the Maternity and Infant Care Scheme, Primary Childhood Immunisation Scheme, etc.

Despite reductions to the payment rates of health contractors made under FEMPI legislation, the total fees paid to GPs under the GMS scheme have increased from just over €472 million in 2009 to approximately €525 million in 2017. This increase in fees is largely due to significant developments and investment in GP services introduced in recent years, with more services being made available to our citizens and additional financial support provided by the HSE.

The Public Service Pay and Pensions Act 2017 now allows the setting and varying of contractor payments on a non-emergency statutory basis. It is my intention to put in place a new multiannual approach to fees in return for service improvements and contractual reforms based upon health policy considerations and engagement with representative bodies.