Tuesday 24 October 2017

Shortage of GPs poses threat to Varadkar's health cover plan rollout

A shortage of family doctors threatens to hold up the rollout of free GP care for everyone in the country.

Health Minister Leo Varadkar has said he plans to push ahead with extending free GP care to the entire population, while parking the reform of the insurance system.

However, the Irish Independent understands a shortage of GPs is a key reason behind the need to implement the free GP care slowly.

Senior Government sources now say there are simply not enough GPs to cope with the number of patients and the level of service it is intended to provide.

A representative body for family doctors, the Irish College of General Practitioners has warned of a “manpower crisis”, with new graduates emigrating and established GPs retiring.

Nearly 30pc of GPs will retire in the next 15 years and 22pc of the existing workforce is only part-time.

New research in the sector, to be published in the coming month, is believed to show that a third of trainee doctors are “actively” considering emigration.

GPs are concerned about an increase in workload and a lack of resources for follow-up treatment for patients and a lack of clarity around the Government's plans.

"There are a number of established GPs openly talking about the possibility of not staying in business because of uncertainty about their future," an ICGP spokesperson said.

Up to €400m a year will be needed to pay for the provision of free GP care for all. Funding has been allocated to cover the cost of free GP care for the under-sixes and the over-70s. But the major cost and pressure on the system will come into play when the adult population are being covered.

Mr Varadkar has deliberately avoided being pinned down to any time-line for the roll-out of the scheme, which has the strong backing of the Labour Party. Writing in yesterday's Irish Independent, he admitted it "might take a bit longer than originally planned", but said it would go ahead. In his article, he also revealed he was delaying the Government's controversial plan to force everyone to have health insurance.

Mr Varadkar got the support of Labour in delaying the introduction of the universal health insurance plan - and the roll-out of GP care.

This year, €36m was allocated to provide free GP care to children under six. But this money won't be spent in 2014, as the free GP cards have not yet been introduced.

The Government has also agreed to provide €18m for cover for everyone over the age of 70. These two groups are expected to be covered by next year. The next group to get free GP care will be primary school children, aged six to 12, and then secondary school children aged 13-18. The main adult population, aged 18 to 69, will be last to be covered under the plan.

Mr Varadkar said the big shift that needed to happen was treatment in the community through primary care.

He said the roll-out of free GP care was the biggest extension of a social provision since Donogh O'Malley drew up a plan to introduce free secondary school education in the late 1960s.

"It's an enormous project in its own right," he said.

Although Mr Varadkar is parking the introduction of Universal Health Insurance, the minister said the implementation of the policy and ending the two-tier health system was still "the vision".

After saying the deadline of 2019 was "too ambitious", he said he still anticipated it would be introduced in the 
lifetime of the next government.

In his first big decision since taking office, the minister announced the postponement of the Government's big reform agenda.

After the 2011 election Fine Gael and Labour agreed to introduce UHI by 2019. The policy would give everybody an insurance policy that would guarantee free GP visits, plus basic hospital cover for regular treatments.

Tanaiste Joan Burton strongly supported Mr Varadkar's announcement and threw her weight behind the provision of free GP care. She said reform in the health system must be done in stages.

She also criticised the Dutch model of UHI, on which the plan in this country is based. Ms Burton said colleagues in the Netherlands told her it took over a decade to implement and it turned out to be far more expensive than appropriate for taxpayers.

Mr Varadkar's announcement of a delay in UHI prompted calls from Sinn Fein health spokesman Caoimhghin O Caolain for the policy to be scrapped completely.

Fianna Fail health spokesman Billy Kelleher said the Department of Public Expenditure had estimated the average annual cost of a policy under the UHI plans will be in the region of €1,600.

"This will create a huge burden for individuals and families who are already struggling with additional taxes brought in by this Government," he said.

The minister also said the cuts to the health budget last year have "proven to be unrealistic". Mr Varadkar said the overrun in the health service this year will be €450-€500m.

The minister pointed out both Finance Minister Michael Noonan and Public Spending Minister Brendan Howlin were health ministers in the past. During their time in office, the budget for health went up, he said.

Mr Varadkar has also dismissed suggestions he was handed the health portfolio to stop his ambitions.

"I think I was probably put there because the Taoiseach has confidence in me," he said on RTE Radio One.

Irish Independent

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