Alan Farrell (Dublin Fingal, Fine Gael)
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1639. To ask the Minister for Health the efforts his Department is making to develop multidisciplinary teams within GP services; and if he will make a statement on the matter. [17573/23]

Alan Farrell (Dublin Fingal, Fine Gael)
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1640. To ask the Minister for Health the efforts his Department is making to increase the number of general practice nurses in the State; and if he will make a statement on the matter. [17574/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 1639 and 1640 together.

GPs are private practitioners, and while most hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders, as private practitioners GPs manage their own practices and may employ practice staff as they see fit and as suitable to the particular needs of their practice.

Under the GMS scheme, GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary. The rate payable depends on the GP's GMS panel size and the level of experience of the nurse or secretary. A practice manager subsidy is also available. In addition, GPs working in rural areas who meet the qualifying criteria will qualify for an annual rural support allowance, a support is also available to GPs working in urban areas of deprivation, and contributions are made towards locum costs for various GP leave arrangements.

Furthermore, as provided for in Budget 2023, a significant package of additional practice supports is being prepared in the context of the expansion of eligibility for GP care without charges to people who earn the median household income or less.

There are currently approximately over 2,000 practice nurses in Ireland, although a portion of these work part-time in general practice. Practice nurses pay a key role in general practice and provide a wide range of services to patients. I'm delighted that University College Dublin have recently launched, with support from my Department and funding under Sláintecare, a new graduate diploma in Primary Care Nursing Practice. On a pilot two year basis, 60 students are to commence this course in September. The programme acknowledges the important role of practice nurses and nurses in primary care, and helps develops career pathways in general practice.

The Enhanced Community Care (ECC) programme also provides for patients to be referred by GPs on to other healthcare professionals as necessary, with care being provided locally in the community. Community Healthcare Networks facilitate the provision of multidisciplinary care to patients requiring access to primary care services such as occupational therapy, physiotherapy, speech and language therapy, psychology, dietetics, podiatry, and public health nursing services in the community setting. Referral by GPs to these services ensures that patients receive multidisciplinary care through an integrated and co-ordinated approach by these health and social care professionals.

I recently published the Terms of Reference for a Strategic review of General Practice which is to commence shortly and to be completed this year. The review, with input from stakeholders, will examine the broad range of issues affecting general practice, and will set out the measures necessary to deliver a better general practice. Capacity in general practice, the expansion and support of the GP team, and consideration for the development of other roles that would improve service delivery, are areas to be examined under the review.

Alan Farrell (Dublin Fingal, Fine Gael)
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1641. To ask the Minister for Health to provide an update on work being done by his Department to develop career development pathways for GPs; and if he will make a statement on the matter. [17575/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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GPs are private practitioners, most of whom hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders. Our model of general practice is based on private practice, which allows GPs to develop their practices and sub-specialisations in line with the particular needs of their patients and their own career ambitions.

The responsibility for GP training transferred from the HSE to the Irish College of General Practitioners (ICGP) in 2021. The number of doctors entering GP training has increased approximately ten percent year on year from 2019, rising from 193 in 2019 to 258 in 2022, and a further large increase is planned for this year. It is aimed to have 350 training places available for new entrants per year by 2026.

The ICGP education programme also provides a wide range of continuous medical education for trained GPs and professional development opportunities to allow GPs to meet the relevant Medical Council requirements to maintain professional competence. Further training is available in clinical areas such as dermatology, older person care and women's health and also in areas of practice management.

Under the GMS scheme, a number of practice supports are provided for, including staff supports and supports for rural practices and practices in deprived urban areas. Contributions are also made to eligible GMS GPs towards locum expenses for leave taking purposes including study leave.

I recently published the Terms of Reference for a Strategic review of General Practice which is to commence shortly and will be completed this year. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice, including issues related to GP training, and will set out the measures necessary to deliver a more sustainable general practice.

Alan Farrell (Dublin Fingal, Fine Gael)
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1642. To ask the Minister for Health the efforts his Department is making to boost the number of GPs in rural areas; and if he will make a statement on the matter. [17576/23]

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. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.

Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. Currently there are 2,539 GPs contracted to provide services under the GMS Scheme.

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.

Under the 2019 GP Agreement additional annual expenditure provided for general practice has been increased now by €211.6m. This provides for significant increases in capitation fees for participating GMS GPs, and new fees and subsidies for additional services. Improvements to GP’s maternity and paternity leave arrangements and a support for GPs in disadvantaged urban areas, have also been provided for.

An enhanced supports package for rural GP practices was introduced previously to support rural GPs, these supports have been increased by 10% under the 2019 GP Agreement. In addition, practices in receipt of rural practice supports attract the maximum allowable rates for practice staff support subsidies and locum contributions for leave taking. Specific fees are also in place for dispensing doctors (who operate in rural areas), these have been increased by 28% under the Agreement.

The number of doctors entering GP training has increased approximately ten percent year on year from 2019, rising from 193 in 2019 to 258 in 2022, and a further large increase is planned for this year. Following the transfer of responsibility for GP training from the HSE to the Irish College of General Practitioners (ICGP), it is aimed to have 350 training places available for new entrants per year by 2026.

These measures will make general practice in Ireland a more attractive career choice and will see an increase in the number of GPs working in the State.

Furthermore, I recently published the Terms of Reference for a Strategic review of General Practice which is to commence shortly and will be completed this year. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice in general and in rural areas specifically, and will set out the measures necessary to deliver a better general practice.

Alan Farrell (Dublin Fingal, Fine Gael)
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1643. To ask the Minister for Health the efforts being made to reduce the administrative burden on GPs; and if he will make a statement on the matter. [17577/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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GPs are private practitioners, and while most hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders.

Under the GMS scheme, GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary, the latter would commonly perform a range of administrative duties. The rate payable depends on the GP's GMS panel size and the level of experience of the nurse or secretary. A practice manager subsidy is also available.

In addition, as provided for in Budget 2023, a significant package of additional practice supports is being prepared in the context of the expansion of eligibility for GP care without charges to people who earn the median household income or less.

As part of its commitment to GP practice, the HSE continue to invest in the development of many new features within GP practice management systems in an effort to expand their capabilities, improve patient care and facilitate a reduction in administrative overheads for busy GP practices.

Practice systems have been continuously developed to support the chronic disease management (CDM) programme and digitally enable the submission of both the data required to manage the CDM programme and the data required for reimbursement; a single submission now covers both.

Through a combination of technology and regulatory changes, the pandemic saw the rapid deployment of new facilities to support electronic transfer of prescriptions via Healthmail, access to teleconsultations, the introduction of electronic referrals for patients that required Covid testing and system enhancements to support GP practices administration of Covid vaccinations, digitally enabling the reimbursement of GPs as an integral part of the data submission for the vaccination. This capability was subsequently extended to support the administration of flu vaccines last winter, eliminating much of the administration overhead associated with the older, paper based process.

In recent years we have also seen the introduction of electronic sick certs in lieu of the older, paper based forms, again in an effort to streamline processes and leverage digital to reduce administrative overhead.

Whilst the impact of these initiatives in some cases pushed back the delivery of other ICT related initiatives, as described under the 2019 GP Agreement, the planned development of other eHealth initiatives, such as a full electronic prescribing, the national summary and shared care record programmes, we anticipate will also help improve care and reduce the administration burden on GP practices.

Alan Farrell (Dublin Fingal, Fine Gael)
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1644. To ask the Minister for Health if he will comment on the work his Department is undertaking to increase the number of intern doctors selecting general practice; and if he will make a statement on the matter. [17578/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Government is aware of the workforce issues currently facing general practice and in particular the need to increase the number of GPs practising across the country to ensure patients continue to have access to GP services.

A number of measures have been taken to make general practice in Ireland a more attractive career choice for doctors, and the positive impact of these measures is being seen in the increased number of doctors both applying for and undertaking GP training.

Under the 2019 GP Agreement additional annual expenditure provided for general practice has been increased now by €211.6m. This provides for significant increases in capitation fees for participating GMS GPs, and new fees and subsidies for additional services. Improvements to GP’s maternity and paternity leave arrangements and a support for GPs in disadvantaged urban areas have been provided for, and the supports for rural GP practices have also been increased.

The number of doctors entering GP training has increased approximately ten percent year on year from 2019, rising from 193 in 2019 to 258 in 2022, and a further large increase is planned for this year. Following the transfer of responsibility for GP training from the HSE to the Irish College of General Practitioners (ICGP), it is aimed to have 350 training places available for new entrants per year by 2026.

In addition, the number of applications from doctors to undertake GP training has also increased year on year from 2019, with 446 applications received in 2019 rising to a record 968 applications received this year.

Furthermore, I recently published the Terms of Reference for a Strategic review of General Practice which is to commence shortly and will be completed this year. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice, and will set out the measures necessary to deliver a more sustainable general practice. GP training and the need to ensure an adequate supply of general practitioners to meet the changing needs of the population is one of the key issues to be examined under the review.