Colm Burke (Cork North Central, Fine Gael)
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776. To ask the Minister for Health the action his Department will take to increase the number of general practitioners by an additional 1,260 to 1,660 general practitioners by 2028 in order to meet the needs of population growth and the significant growth of those aged 65 and over 85 years of age who are naturally high users of the service [5005/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Government is aware of the workforce issues currently facing general practice and is working to ensure patients across the country continue to have access to GP services and that general practice is sustainable in all areas into the future.

Several measures to increase the number of practicing GPs have been undertaken in recent years. Changes have been made to the entry provisions to the GMS scheme to facilitate more flexible/shared GMS contracts, and to the retirement provisions for GPs under the GMS scheme. An enhanced supports package for rural GP practices was also introduced.

Recent developments in relation to general practice, in particular the 2019 Agreement on Contractual Reform and Service Development, have helped to re-establish general practice in Ireland as an attractive career choice.  The additional investment, which will amount to €210 million annually once the Agreement is fully implemented, provides for an increase in capitation fees, improved maternity and paternity arrangements as well as increased rural practice supports. In addition, targeted on-going funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas.

The number of entrants to GP training has increased from 120 in 2009 to 233 in 2021, with large increases made in recent years. Further increases are expected as responsibility for training has transferred from the HSE to the Irish College of General Practitioners.

These measures will see an increase in the number of GPs working in the State, improving access to GP services for patients throughout the country. 

Colm Burke (Cork North Central, Fine Gael)
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777. To ask the Minister for Health if consideration will be given to providing an enhanced range of supports including but not exclusively tax relief to assist in the funding of premises or critical equipment, infrastructural equipment including information technology systems and medical equipment to assist general practitioners establishing practices particularly those starting off in their career; and if he will make a statement on the matter. [5006/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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GPs are private contractors, most of whom hold contracts with the HSE for the provision of medical services such as contracts under the General Medical Services (GMS) Scheme for the provision of medical services without charge to patients who hold a medical card or GP visit card. In addition to direct remuneration for medical services provided under the GMS contract, the contract provides a range of GP practice supports including practice staff supports and supports for rural practices and for those working in disadvantaged urban areas. 

As GPs are self-employed practitioners, they therefore may establish practices at a place of their own choosing. 

The 2019 GP Agreement includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future, including ensuring the sustainability of the business model for practices.  The outcome of this review will inform future contractual changes.

Colm Burke (Cork North Central, Fine Gael)
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778. To ask the Minister for Health if consideration will be given to providing a partnership pathway support funding model to allow for existing general practitioners to take on assistants to enter into succession arrangements to take over the practice on a phased basis; and if he will make a statement on the matter. [5007/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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GPs are private contractors, most of whom hold contracts with the HSE for the provision of medical services such as contracts under the General Medical Services (GMS) Scheme for the provision of medical services without charge to patients who hold a medical card or GP visit card. In addition to direct remuneration for medical services provided under the GMS contract, the contract provides a range of GP practice supports including practice staff supports and supports for rural practices and for those working in disadvantaged urban areas.

Under the 2019 GP Agreement on Contractual Reform and Service Development, a working group consisting of members from the Department of Health, the HSE and the IMO, has been established to review current GMS succession arrangements in order to streamline succession arrangements and reduce the succession timeframe. The working group made significant progress prior to interruption by the Covid-19 pandemic, it is hoped that this work will be finalised in the near future. However, there are currently no plans to implement funding supports related to succession arrangements.

The 2019 GP Agreement includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future.  The outcome of this review will inform future contractual changes.

Colm Burke (Cork North Central, Fine Gael)
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779. To ask the Minister for Health the action his Department will take to adjust and update the general practitioners practice team model to take account both of the broad range of skills required in practice to meet new models of care and to free up skilled personnel for more complex tasks; and if he will make a statement on the matter. [5008/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Government is committed to developing primary and community services across the country. We also remain committed to the continued development of GP capacity to ensure that patients continue to have access to GP services.

GPs are self-employed practitioners and therefore may establish practices at a place of their own choosing and employ additional staff as they see fit. Under the GMS scheme, the HSE contracts GPs to provide medical services without charge 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. Under the GMS scheme, GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary.  Group practices may also qualify for a subsidy to employ a practice manager.

Recent developments in relation to general practice, in particular the 2019 Agreement on Contractual Reform and Service Development, have helped to re-establish general practice in Ireland as an attractive career choice.  The additional investment, which will amount to €210 million annually once the Agreement is fully implemented, provides for an increase in capitation fees, improved maternity and paternity arrangements as well as enhanced supports for rural practices. In addition, targeted funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas.

The 2019 GP Agreement includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future.  The Government is open to considering other options of support for general practice as part of the strategic review. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.

 In Budget 2022, the Minister secured annual investment of €195m to enable the continued delivery of the Enhanced Community Care (ECC) Programme. Amongst other initiatives, the funding will allow for the rollout of 96 Community Healthcare Networks (CHNs) to be completed across the country by the end of 2022.  These networks will be central to the development of improved primary and community services. They will involve new ways of working and are designed to empower local GPs, nurses, and other health professionals to lead at the local level, with key roles for GP Leads and Network Managers.

The ECC programme represents a significant expansion in primary care capacity, and will see some 3,500 additional staff recruited overall, with around 2,300 staff to be recruited in 2022, with a particular focus on nursing and health and social care professionals  thereby delivering on the Sláintecare vision of enabling the provision of the right care, at right time, in the right place.

Colm Burke (Cork North Central, Fine Gael)
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780. To ask the Minister for Health if consideration will be given to adjusting the general practitioner practice team model in order to support broader general practitioner practice team members by expanding the grant aid available to take on additional nursing staff; and if he will make a statement on the matter. [5009/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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GPs are self-employed practitioners and therefore may establish practices at a place of their own choosing and employ additional staff as they see fit. Under the GMS scheme, the HSE contracts GPs to provide medical services without charge 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.

Under the scheme, GPs can claim a subsidy towards the cost of employing a practice nurse and/or a practice secretary.  Payment is made to participating doctors with a panel size of at least 100 patients and payment increases in bands of 100 with a maximum payment applicable at a panel size of 1,200. The subsidy rate applies to staff employed on a full-time basis. In relation to staff not employed on a full-time basis, payment is made on a pro rata basis.

Recent developments in relation to general practice, in particular the 2019 Agreement on Contractual Reform and Service Development, have helped to re-establish general practice in Ireland as an attractive career choice.  The additional investment, which will amount to €210 million annually once the Agreement is fully implemented, provides for an increase in capitation fees, improved maternity and paternity arrangements as well as enhanced supports for rural practices. In addition, targeted funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas.

The 2019 GP Agreement includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future.  The Government is open to considering other options of support for general practice as part of the strategic review. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.

Colm Burke (Cork North Central, Fine Gael)
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781. To ask the Minister for Health if consideration will be given to adjusting the general practitioner practice team model to provide initiatives and support for the recruitment of particular allied health professional expertise on a full-time or sessional basis to benefit the broad needs of the patient population including physiotherapists, counselling and pharmacy support; and if he will make a statement on the matter. [5010/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Government is committed to developing primary and community services across the country. We also remain committed to the continued development of GP capacity to ensure that patients continue to have access to GP services.

GPs are self-employed practitioners and therefore may establish practices at a place of their own choosing and employ additional staff as they see fit. Under the GMS scheme, the HSE contracts GPs to provide medical services without charge 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. Under the GMS scheme, GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary.  Group practices may also qualify for a subsidy to employ a practice manager.

Recent developments in relation to general practice, in particular the 2019 Agreement on Contractual Reform and Service Development, have helped to re-establish general practice in Ireland as an attractive career choice.  The additional investment, which will amount to €210 million annually once the Agreement is fully implemented, provides for an increase in capitation fees, improved maternity and paternity arrangements as well as enhanced supports for rural practices. In addition, targeted funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas.

The 2019 GP Agreement includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future.  The Government is open to considering other options of support for general practice as part of the strategic review. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.

In Budget 2022, the Minister secured annual investment of €195m to enable the continued delivery of the Enhanced Community Care (ECC) Programme. Amongst other initiatives, the funding will allow for the rollout of 96 Community Healthcare Networks (CHNs) to be completed across the country by the end of 2022.  These networks will be central to the development of improved primary and community services.   They will involve new ways of working and are designed to empower local GPs, nurses, and other health professionals to lead at the local level, with key roles for GP Leads and Network Managers.

The ECC programme represents a significant expansion in primary care capacity, and will see some 3,500 additional staff recruited overall, with around 2,300 staff to be recruited in 2022, with a particular focus on nursing and health and social care professionals.

Colm Burke (Cork North Central, Fine Gael)
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782. To ask the Minister for Health if consideration will be given for the development of a structured care programme in the area of women’s health within general practice which would deal exclusively with reproductive health, including contraception, maternity care and menopause; and if he will make a statement on the matter. [5011/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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Improving women’s health outcomes is a key priority for me and this Government. We made a strong commitment to Promoting Women’s Health in the Programme for Government and are fully committed to the development and improvement of Women’s Health services and to working with women and girls to improve their health across the whole life cycle.

This commitment has been reflected within Budget 2022, in the allocation of €31 million for new development funding to specifically support women’s health.

Underscoring the government’s commitment to Women’s Health has been the establishment of a Women’s Health Taskforce in September 2019 to improve both health outcomes and experiences of healthcare for women and girls. The Irish College of GPs (ICGP) are active members of the Women's Health Taskforce and continue to be engaged on how women's health can be better considered within the primary care setting.

Related activity includes a number of education and training courses run throughout the year, including the establishment in September 2021 of a GP Education Course in the area of Community Gynaecology which includes topics such as contraception, sexual health and fertility. In addition, funding has been provided through the Women's Health Fund to develop a 'quick reference guide' for GPs on the menopause, to support primary care provision in this area.

An ICGP post of Clinical Lead for Women’s Health in General Practice, the first such post in Ireland, is currently being progressed. Once in place, the Clinical Lead will provide the essential leadership to drive forward an ambitious agenda to enable a comprehensive life-course approach to women’s health in general practice.

Colm Burke (Cork North Central, Fine Gael)
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783. To ask the Minister for Health if a review will be carried out into the current package of supports for rural general practitioner practices, taking into account the fact that these supports would continue to be developed and enhanced to meet the very specific requirements of patients in these rural areas to ensure continuity of care for patients and that general practice is sustainable; and if he will make a statement on the matter. [5012/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Government is aware of the workforce issues currently facing general practice, including the limited access to GP services in certain areas. The Government has committed to providing significant additional resources to general practice to help to meet those challenges. We are working to ensure patients across the country continue to have access to GP services and that general practice is sustainable in all areas into the future.

Several efforts to increase the number of practising GPs have been undertaken in recent years. The number of entrants to GP training has increased from 120 in 2009 to 233 in 2021, with large increases made in recent years. Further increases are expected as responsibility for training has transferred from the HSE to the Irish College of General Practitioners. Changes have been made to the entry provisions to the GMS scheme to facilitate more flexible/shared GMS contracts, and to the retirement provisions for GPs under the GMS scheme.

An enhanced supports package for rural GP practices was also introduced.

Recent developments in relation to general practice, in particular the 2019 Agreement on Contractual Reform and Service Development, have helped to re-establish general practice in Ireland as an attractive career choice.  The additional investment, which will amount to €210 million annually once the Agreement is fully implemented, provides for an increase in capitation fees, improved maternity and paternity arrangements as well as enhanced supports for rural practices. In addition, targeted funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas.

The 2019 GP Agreement includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future.  The Government is open to considering other options of support as part of the strategic review. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.