Patient choice of doctor is a bedrock principle of the GMS Scheme for medical card and GP visit card holders. For the vast majority of individuals concerned their choice of doctor is accommodated and they are registered with their GMS GP of choice. In 2022 (last full year data available) out of a total of about 348,000 individuals who were approved for either a GP Visit Card or Medical Card, 3,927 individuals were unable to secure placement with their doctor of choice, or 1.1% of the total. In addition, 3,701 existing GMS patients were reassigned following a change in their place of residence.
For the small number of individuals unable to locate a GP themselves, I can confirm that the long standing process whereby the HSE may assign an eligible person to a GP’s GMS panel remains in place, in accordance with the GMS contract. Where a patient who holds a medical card or GP visit card experiences difficulty in finding a GP to accept them as a patient, the person concerned having unsuccessfully applied to at least three GPs in the area (or fewer if there are fewer GPs in the area) can apply to the HSE National Medical Card Unit which has the power to assign that person to a GP's GMS patient list.
The GP Agreement 2023, which provides for the expansion of GP care without charges to all children under 8 years and to those who earn up to the median household income, does contain arrangements in relation to the assignment of card holders/applicants to GP GMS panels. However, these arrangements do not prevent the assignment of patients and rather are in place to help the equitable distribution of assigned patients across the panels of participating GPs.
In addition, as per the Agreement, a joint HSE and Irish Medical Organisation working group is being established to review the operation of the patient assignment protocol with a view to ensuring that it is framed and operating in a fair, patient- and GP-centred manner.
