David Cullinane (Waterford, Sinn Fein)
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873. To ask the Minister for Health the work that has been carried out to establish the cost of delivering free general practitioner care to all citizens, including on demographics, increased demand, required general practitioner capacity, changes to the general practitioner contract that may be required and any other scoping work; the person in the HSE or in his Department who is tasked with such scoping work; and if he will make a statement on the matter. [37405/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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Several analyses have been undertaken to estimate the future demands for GP capacity, and the related GP expenditure, across a number of eligibility scenarios including universal GP care without charges.

The HSE report on Medical Workforce Planning Future Demand for General Practitioners 2015-2025provides estimates on the additional demand for GPs and the training numbers necessary to meet that demand under different eligibility scenarios including universal GP care. The report notes that to meet the demand for GPs that may be required by 2025, the State would require significant increases to the annual intake for GP postgraduate specialist training.

Building on this work, the HSE publication The Demand for Medical Consultants and Specialists to 2028 and the Training Pipelineto Meet Demandprovides estimates on the demand for GPs by 2028 based on rolling out GP care without charges to the under 18’s and over 70’s as well as universal free GP care.

Measures taken by the Government to increase GP capacity and the number of GPs in the State are already having an impact. There has been a significant increase in the number of GPs entering training in recent years, up from 120 in 2009 to 233 in 2021, with large increases made in recent years. The transfer of responsibility for training to the ICGP, completed last year, will result in further increases in the coming years. 258 GP training places are planned for 2022.

Due to the wide range of payments and variables that must be accounted for, and the requirement to determine the scope of services to be provided to newly eligible cohorts in consultation with the IMO, it is not possible to definitively calculate the cost of universal GP care without charges. However, the 2019 IGEES paper Costing Framework for the Expansion of GP Careprovides a cost estimate for universal GP care, as does the 2018 ESRI study Universal GP care in Ireland: Potential Cost Implications.

Other relevant analyses include the Department of Health’s Health Service Capacity Review 2018which estimates future capacity requirements, including those in primary care, for the period to 2031, and the Projections of Expenditure for Primary, Community and Long-Term Care in Ireland, 2019–2035, based on the Hippocrates Model(July 2021) research paper from the ESRI, which was funded by the Department of Health and which projects expenditure for most primary, community, and long-term health and social care services in Ireland for the years 2019–2035.

Department of Health IGEES staff are currently working on possible options for expanding eligibility to GP care on a phased basis. This analysis includes consideration of costs, demographics, demand and GP capacity.