The Government is aware of the workforce issues facing general practice, including changing demographics, the number of GPs nearing retirement, the difficulties in filling a small number of GMS vacancies, and the impact of the shift towards care centred in the community on general practice. The Government has committed to providing significant additional resources to general practice to help to meet those challenges.
The 2019 Agreement with GPs will see investment in general practice increase by approximately 40% (€210 million) between 2019 and 2023. Specific initiatives benefiting patients arise from the 2019 Agreement, such as the introduction in 2020 of the Chronic Disease Management Programme to facilitate improved care for patients with diabetes, chronic heart disease, COPD, and asthma. As the Programme is rolled out and fully implemented over time, it will mitigate the reliance on hospitals for care of patients with the four conditions.
We have also provided resources to allow GPs to refer patients directly to diagnostic services. As of mid-September 2021, the HSE reported that over 70,000 scans of various modalities have been completed under the community diagnostics programme. Provision of timely direct access to diagnostics to GPs can enable integrated care delivery, reduce ED attendances and facilitate hospital avoidance particularly for the over 75 age group. This programme will be continued into the future, and resources have been allocated in Budget 2022.
In addition, the 2019 Agreement provides for significant increases in capitation fees for participating GPs, and new fees and subsidies for additional services. The Agreement also provides for increased support for GPs in disadvantaged urban areas, and for improvements to maternity and paternity leave arrangements.
The number of GPs entering training has increased steadily over the past number of years, from 120 in 2009 to 233 trainees enrolled this year. Further increases are expected following the transfer of responsibility for training from the HSE to the Irish College of General Practitioners.
GP out of hours service providers play a key role in the delivery of our health service, providing GP care to patients in the community outside of normal GP surgery hours. In recognition of the challenges arising from the Covid-19 pandemic, and to ensure continuity of the service, a financial and service stability arrangement for GP out of hours co-operatives was introduced with effect from 14th March 2020. Under this measure some 14 GP out of hours co-ops are availing of the funding support measure, which has been extended further.