Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 772 and 773 together.

I propose to take PQ 33889/23 & PQ 33890/23 together.

As was announced on the 4^thof July 2023, eligibility for GP visit cards will be extended to people who earn up to the median household income and for children ages 6 & 7 years old.

Approximately 78,000 children aged 6 & 7 who currently access GP care on a private basis will benefit from this measure.

Approximately 430,000 additional persons, who otherwise would have attended their GP on a private basis, are expected to become eligible for free GP care under this expansion, the largest expansion in GP care without charges in the history of the State.

Ensuring that more people can afford to visit their GP gives access to healthcare in the right place - one of the central commitments in the Programme for Government. It also removes the burden on people who may defer GP visits because they simply cannot afford it.

This expansion in care will be implemented with the agreement of the IMO and will put in place a series of capacity supports to allow GPs to recruit additional staff, as well as increases in fees to take account of the likely increase in demand for services. The total financial package will amount to approximately €130 million in a full year, and an estimated €31 million in 2023.

Agreed Fee changes

CapitationChildren aged 6 & 7	€100
Eligible children aged 8 – 12	€100
Eligible individuals aged 13 – 69	10% increase
Capacity supportsAdditional staff	Maximum of €15,000 per GP with a minimum panel size of 500
Retention practice support staff	Existing subsidy increased to 75% of reckonable salary + employer’s PRSI
ContraceptionLong-Acting Reversible Contraception	Alignment of fees with Universal scheme rates
Consultations	1 consultation per annum per GMS patient aged 31 - 44

Revised Capitation Rates

Cohort	Annual Capitation
Child Patient Aged between 6 and 7 years (inclusive)	€100.00
Child Patient Aged between 8 and 12 years (inclusive)	€100.00
Male patient aged 13 years and less than 16 years	€70.71
Male patient aged 16 years and less than 45 years	€90.26
Male patient aged 45 years and less than 65 years	€180.29
Male patient aged 65 years and less than 70 years	€189.92
Female patient aged 13 years and less than 16 years	€71.52
Female patient aged 16 years and less than 45 years	€147.60
Female patient aged 45 years and less than 65 years	€198.10
Female patient aged 65 years and less than 70 years	€211.87

Revised GMS Contraception Rates

	Applicable Services Rendered by a Registered Medical Practitioner on behalf of the Health Service Executive under the General Medical Services Scheme.
Description	Amount
Consultation provided to an eligible woman aged between 31-44 years (inclusive) for the purposes of obtaining a prescription for accessing relevant products.	€55.00
Fitting by a Registered Medical Practitioner of a relevant product that is a Coil for an eligible woman aged over 30 years.	€160.00
Removal by a Registered Medical Practitioner of a relevant product that is a Coil for an eligible woman aged over 30 years.	€50.00
Fitting by a Registered Medical Practitioner of a relevant product that is a contraceptive implant for an eligible woman aged over 30 years	€100.00
Removal by a Registered Medical Practitioner of a relevant product that is a contraceptive implant for an eligible woman aged over 30 years	€110.00

The estimated full year cost of implementing this agreement is set out below.

Item	FYC (€m)
Capitation fees	€41.34
Out-of-Hours	€2
Capacity Supports	€30.71
Contraception	€5.54
Median Income Card Costs	€50.80
Total	€130.39

The applications process for patients will be introduced on a phased basis.

- Applications for children aged 6 & 7 will open on 11 August 2023.

- Applications for the first group under the median-income expansion will commence on 11 September 2023.

- Applications for the full group under the median-income expansion will commence on 13 November 2023.

The new capitation rates will be applicable from 1st August 2023 for GPs that sign up to the new agreement by 9 August.