Written answers
Tuesday, 3 October 2023
Department of Health
General Practitioner Services
David Cullinane (Waterford, Sinn Fein)
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692. To ask the Minister for Health the reason that he has agreed to limit the ability of the HSE to assign patients to GP GMS lists; the date on which this policy commenced; and if he will make a statement on the matter. [42737/23]
Stephen Donnelly (Wicklow, Fianna Fail)
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Patient choice of doctor is a bedrock principle of the GMS Scheme for medical card and GP visit card holders. For the vast majority of individuals concerned their choice of doctor is accommodated and they are registered with their GMS GP of choice. In 2022 (last full year data available) out of a total of about 348,000 individuals who were approved for either a GP Visit Card or Medical Card, 3,927 individuals were unable to secure placement with their doctor of choice, or 1.1% of the total. In addition, 3,701 existing GMS patients were reassigned following a change in their place of residence.
For the small number of individuals unable to locate a GP themselves, the long standing process whereby the HSE may assign an eligible person to a GP’s GMS panel remains in place, in accordance with the GMS contract.
The GP Agreement 2023, which provides for the expansion of GP care without charges to all children under 8 years and to those who earn up to the median household income, does contain arrangements in relation to the assignment of card holders/applicants to GP GMS panels. However, these arrangements do not prevent the assignment of patients and rather are in place to help the equitable distribution of assigned patients across GP’s panels. The Agreement was announced in July 2023 and the terms of the Agreement are applicable to participating GPs.
In addition, as per the Agreement, a joint HSE and Irish Medical Organisation working group is being established to review the operation of the patient assignment protocol with a view to ensuring that it is framed and operating in a fair, patient- and GP-centred manner.
David Cullinane (Waterford, Sinn Fein)
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693. To ask the Minister for Health to outline, in full, the details of the new GMS GP deal agreed over the summer of 2023; and the full extent of changes made to the GMS contract as a result of this deal, in tabular form. [42740/23]
Stephen Donnelly (Wicklow, Fianna Fail)
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The GP Agreement 2023 between the Department of Health, the HSE and the IMO, which was announced July last, is available publicly from the websites of the Department of Health and the HSE. The Agreement provides for the expansion of GP care without charges to all children aged 6 & 7, via the Under 8s Contract, and the expansion of GP care without charges to all those who earn no more than the median household income. The Agreement also provides for a range of additional supports for general practice.
Unfortunately, tabular format is not suitable to capture in full all the provisions of the Agreement. For participating GPs, the Agreement sets out:
- increased capitation fees, an approximate €35 rate increase for GMS patients aged 6 and 7 and a 10% rate increase for GMS patients aged 8 to 69 inclusive.
- a substantial increase to the existing practice staff subsidy rates and a new grant subsidy for additional practice staff up to €15,000,
- a new support for practice staff during maternity leave,
- a €2 million additional support for GP Out of Hours services,
- increased special items of services fees for contraception services for female GMS patients outside the Free Contraception Service,
- the expansion and rollout of phase 3 of the Chronic Disease Management programme, and
- funding for pilot initiatives in relation to hard to fill GMS GP vacancies and locum cover for rural GPs.
The full details of these provisions are set out within the Agreement. The capitation rates and the increased practice staff subsidy rates set out under the Agreement are provided below.
| Capitation Rates applicable to GPs participating under the GP Agreement 2023 | |
|---|---|
| Child Patient Aged under 6 years | €125 |
| Child Patient Aged between 6 and 7 years (inclusive) | €100 |
| Child Patient Aged between 8 and 12 years (inclusive) | €100 |
| Male patient aged 13 years or more and less than 16 years | €70.71 |
| Male patient aged 16 years or more and less than 45 years | €90.26 |
| Male patient aged 45 years or more and less than 65 years | €180.29 |
| Male patient aged 65 years or more and less than 70 years | €189.92 |
| Patient aged 70 years or more residing in the community | €403.31 |
| Patient aged 70 years or more residing in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks | €644.63 |
| Female patient aged 13 years or more and less than 16 years | €71.52 |
| Female patient aged 16 years or more and less than 45 years | €147.60 |
| Female patient aged 45 years or more and less than 65 years | €198.10 |
| Female patient aged 65 years or more and less than 70 years | €211.87 |
| Practice Staff Support Subsidy Rates under the GP Agreement 2023 | |
|---|---|
| Nursing subsidy (per year) - 1 years’ experience | €35,210.25 |
| Nursing subsidy (per year) - 2 years’ experience | €37,284.00 |
| Nursing subsidy (per year) - 3 years’ experience | €39,353.25 |
| Nursing subsidy (per year) - 4 or more years’ experience | €43,725.75 |
| Practice administrator subsidy (per year) - 1 years’ experience | €22,844.25 |
| Practice administrator subsidy (per year) - 2 years’ experience | €24,749.25 |
| Practice administrator subsidy (per year) - 3 or more years’ experience | €26,652.00 |
| Practice manager subsidy (per year) | €41,643.75 |
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