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State payments to GPs up by more than 50% since 2019

Health Service Executive payments to general practitioners in 2022 at €785m, not including €102m in Covid payments

In Ireland, GPs are private operators who contract to provide medical services to the State in return for payment. Photograph: Getty Images

Paul Cullen
Mon Mar 4 2024 - 06:00

State payments to GPs have increased by one-third in three years as the number of services provided by family doctors has broadened.

When Covid-19-related payments are included, the increase in payments to GPs is 51 per cent.

Total funding for general practice amounted to €784.9 million in 2022, according to figures provided by the Health Service Executive, up from €589 million in 2019.

This figure does not include almost €410 million in Covid-19 related supports paid out over three years of the pandemic.

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Total HSE payments to GPs, not including Covid-19 supports, amounted to €254,000 per doctor in 2022. When the pandemic payments are included, the average payment was €287,000.

In Ireland, GPs are private operators who contract to provide medical services to the State in return for payment. They bear the costs of running a surgery, including staff and premises, themselves. They are free to take on private work — the average price per GP consultation for a non-medical cardholder is €50-70. The number of private patients varies hugely between different doctors.

In 2022, the HSE paid €714.4 million in fees and allowances to GPs, and a further €70.5 million under a chronic disease management programme introduced in 2020.

Covid-19 payments, which include respiratory and vaccination appointments, including remote consultations, amounted to €140 million in 2020, €174.6 million in 2021 and €102.3 million in 2022.

Under the Sláintecare reform programme for health, services are to be reoriented towards general practice and the community, and away from hospitals. As well as monitoring chronic health conditions in medical-card patients, GPs can now order scans, a change described by the HSE as a “game-changer” in community health.

The 334,843 scans delivered last year have cut the number of referrals to hospital outpatient clinics and consultants by half, it claims.

There are 3,091 GPs in Ireland with a public contract; another 500 don’t hold HSE-funded contracts.

Almost 7.5 million individual claims are paid to GPs yearly in respect of 29 million consultations a year.

However, there are shortages of GPs in many parts of the country, amid fears this could worsen. One-quarter (24 per cent) of GPs are aged 60 and over, 14 per cent are 65-plus and 5 per cent are 70-plus. One-quarter of GPs (26 per cent) are working part-time.

To tackle the shortage of GPs and the ageing of the workforce, the number of training places has more than doubled, from 120 a year over a decade ago to 286 last year. This year, 350 GP training places are being offered.

It is planned the total number of trainees undertaking the four-year programme will increase from the current 1,044 to 1,300 in 2026 — a 25 per cent rise.

To address immediate shortages, particularly in rural areas, 112 non-EU doctors were recruited last year to work in rural general practice and areas of urban deprivation; 87 have already begun work.

The HSE says it plans to recruit another 250 non-EU doctors this year under this scheme, using €6 million funding provided in Budget 2024. Recruits must work in a GP practice for two years, after which they can set up independently.

The new initiative has had “a very immediate impact on GP shortages”, it says, particularly in the southwest, southeast, midlands and west.

Entitlement to a GP visit card was extended to six- and seven-year-olds, and people earning less than the median household income, last autumn. Just 3.5 per cent of those eligible under the changed income criteria have so far applied for a card.

Under a €130 million deal with GPs last year, capitation rates payable to GPs for children and adults were increased, additional financial supports were provided for staff and payments for contraceptive services were improved.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times

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