Dáil Éireann Debate, Tuesday - 24 January 2023
577. Deputy Patrick O'Donovan asked the Minister for Health the financial amount that was allocated by his Department for the purposes of carrying out an ESRI report into the costs of extending GP care to the whole population; the number of GPs that were contacted as part of the report; and if he will make a statement on the matter. [2983/23]
View answerThe recent publication by the ESRI, ‘Extending eligibility for general practice care in Ireland: cost implications’ is part of the Joint Research Programme in Healthcare Reform is a programme agreed between the Department of Health and the ESRI which commenced in July 2014.
The Research Programme in Healthcare Reform seeks to use economic analysis to explore issues in relation to health services and health spending as well as population health. The intention of this programme is to undertake research in health economics and policy which contributes to the evidence base needed for the reform and development of healthcare policy in Ireland. This programme follows a model used by the ESRI in a range of research areas, where experienced researchers undertake research of the highest academic quality that is focused on current policy challenges.
The programme was recently renewed for three-years, commencing on January 1st, 2022. The Department contributes a grant of €547,500 per annum for three years, with €60,000 of this earmarked for the ‘Behavioural workstream’ of the programme. Since January 2022 four reports have been developed as part of this programme with an additional report partly funded by the programme. In addition to reports and papers, the development of a healthcare demand and expenditure model, Hippocrates, is a major focus and output of the Joint Research Programme.
The ESRI provide the following comment on the research process for the paper, including consultation:
“The Department of Health/ESRI Research Programme in Healthcare Reform is overseen by a steering group that consists of ESRI, Department of Health, and external members. On an annual basis, the steering group agrees on a programme of work for the upcoming year. Costing an extension to eligibility for general practitioner care (GP) in Ireland was identified as one of the research questions for 2022 by the research team and steering group.
Engagement with policymakers, practitioners and stakeholders is an on-going feature of ESRI work across all research areas, including discussion with GPs and other healthcare professionals about aspects of the healthcare system. However, GPs were not involved in the development of the specific research question or methods in this report.
The aim of this research was to estimate the cost implications of extending eligibility for GP services to the whole population, a key recommendation of Sláintecare.
In the analysis, projections of the cost associated with increasing eligibility for GP care were estimated using the ESRI’s healthcare projection model, the Hippocrates Model. The Hippocrates model is a macro-simulation model which has previously been used to project demand and expenditure for health and social care services, as well as acute hospital bed capacity and workforce. National and international evidence underlies the assumptions in the model. In addition to the cost of extending eligibility, the analysis incorporated other cost drivers including population growth and ageing, and growth in the cost of care delivery over time.
All published ESRI reports are subject to an extensive peer review process. Research series reports (including the current report) are peer reviewed by two internal ESRI staff members, as well as one external reviewer. In addition, the draft report was sent to the steering group members for comment.
The ESRI is an independent research institute, and the research is free of any expressed ideology or political position. Independence is maintained through the publication of all research reaching the appropriate academic standard, irrespective of its findings or who funds the research.”
The Department of Health welcomes the key findings of the paper on the cost implications of gradually increasing eligibility and access to GP services. The ESRI shows that universal expansion of GP visit cards could reduce household spending on GP services by €372m annually.
The Strategic Review of general practice, which will commence shortly, will examine the steps necessary to ensure that general practice is properly structured and resourced in the context of implementing the Sláintecare vision. The Terms of Reference for this Department led Strategic Review will be published shortly .
The Government will consider future eligibility to GP services, including timelines, in the context of ongoing wider policy and health service planning considerations and will be informed by evidence and the Strategic Review.
