Richard Boyd Barrett
Question:735. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full-year cost of providing free primary care (including GPs) for all; and if he will make a statement on the matter. [24182/23]
View answerTuesday, 23 May 2023
Questions (735)
Written answers
Under the GMS scheme GPs receive a range of payments including capitation payments, fee per service payments and practice supports. Extending GP care without charges to all citizens who do not currently hold a medical card or GP visit card would encompass a further 3 million people approximately. It is not possible to definitively calculate the cost of universal GP care without charges given the wide range of payments and variables that have to be accounted for.
Such a calculation would require a complex and detailed modelling exercise to account for a range of demographic changes, future projections of service demands and variations in the number of GPs and the allowances that could be paid.
Additionally, the fees payable to GPs could only be determined following agreement with the IMO on the scope and content of the general practitioner service to be provided, as well as on the future of the various other supports provided to general practice. For these reasons, it is not possible to give the actual cost of extending GP care without fees to further cohorts.
However, the following recent papers have estimated the cost of universal GP care without charges: the 2018 ESRI study Universal GP care in Ireland: Potential Cost Implications, the 2019 IGEES paper Costing Framework for the Expansion of GP Care, and the 2023 ESRI report Extending Eligibility for General Practitioner Care in Ireland: Cost Implications .
With regard to primary care dental services, the national approach to future oral health service provision will be informed by Smile agus Sláinte, the National Oral Health Policy (2019). The aim of the policy is to develop a model of care that will enable preventative approaches to be prioritised, improve access, and support interventions appropriate to current and future oral health needs. The cost of providing free dental care to the whole population would depend on a number of factors, including the underlying oral health of the population and the level of take-up of such services.
Over the last number of years, several pieces of detailed policy analysis have been undertaken to assess various aspects of expanding eligibility for near or full universal access to primary care and other care sectors and the associated additional costs for the Exchequer. These include the Expert Group Report on Resource Allocation and Financing of the Irish Health System (2010), the White Paper on Universal Health Insurance (2014) and associated costings, and the Committee on the Future of Healthcare Sláintecare Report (2018).
Sláintecare makes the commitment to providing free or affordable access to healthcare to all, while recognising that the delivery of universal GP care without charges must be done on a phased basis. The Strategic Review of General Practice, the Terms of Reference for which I published last month, will examine the broad range of issues affecting general practice and set out the measures necessary to deliver a more sustainable GP service. Under this review, consideration is to be given to the scope of services to be provided to patients on a universal basis, and also to developing the support model necessary to underpin the provision of sustainable GP services under the Sláintecare vision.