Free GP care for all would cost €881m and could be rolled out by 2026, ESRI says

Free GP care could be introduced for the entire population within three years at a maximum cost to the State of €881 million, according to new research.

Providing access for all to a family doctor would reduce the amount people spend on GP services each year from an estimated €467 million to €95 million, according to the Economic and Social Research Institute (ESRI).

However, it warns that there may not be enough GPs to meet the extra demand a free system would generate as the population ages and grows.

The research suggests the cost of extending free GP care to all in 2026 would vary between €381 million and €881 million, depending on population growth and ageing, take-up rates and payments made to doctors.

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[ Analysis: Free GP care could work, if there are enough doctors ]

Medical card

Introducing the measure would result in an additional 1.9-2.3 million GP visits in 2026, the study estimates. This is equivalent to about 12 extra visits per doctor per week. The study also examines an alternative of providing everyone who does not currently have free GP care with two free visits to the doctor each year – it is estimated this would cost between €193 million and €349 million in 2026.

About 56 per cent of the population does not have a medical card or GP visit card. Currently, children under six and adults over 70 are entitled to a GP visit card. Budget 2023 included funding for extending eligibility to people who earn less than the median income, and 70,000 children aged six and seven.

[ Free GP care for all would overwhelm health service, IMO says ]

The research looked at two sets of scenarios based on age and income. In the first approach, free GP care would be extended year by year for different age groups; this year, for six- and seven year olds; in 2024, for 50-69 year olds; in 2025, to eight to 17 year olds; and in 2026, to 18-49 year olds. The projected cost to the State here was estimated at €462 million to €881 million.

Alternatively, the measure could be extended income-wise in three tranches between now and 2026. The cost of this approach, which is predicted to have a lower uptake, was estimated at €381 million to €881 million.

[ Doctors concerned over decision to extend free GP care to additional 430,000 people ]

Universal healthcare

Dr Sheelah Connolly, lead author of the report, said increasing the number of people entitled to free GP care would help achieve the Sláintecare objective of moving towards a universal healthcare system.

But she warned there may not be a sufficient number of GPs available to deliver the additional visits required by an ageing and growing population, as well as catering for an increase in the number of people eligible for free GP care in the coming years.

[ Extra 120 GPs needed to extend free care to children aged seven and eight, conference told ]

“If there are not sufficient GPs to meet the additional demand for their services, then, while financial barriers to access may be removed, other barriers including long waits or no availability could hinder access, thereby undermining the universality of the system.”

Spending on general practice is low compared to other sectors, the study points out. In 2019, about €1 billion was spent on general practice, compared to €2.3 billion on community pharmaceuticals and €2 billion on long-term residential care. As a proportion of overall health expenditure, the additional cost of free GP care for all is likely to be “relatively low”, the authors say.