Wednesday 21 February 2018

Reilly's plan for free GP care doomed by €332m bill

Minister for Health James Reilly TD. Photo: Gareth Chaney Collins
Minister for Health James Reilly TD. Photo: Gareth Chaney Collins

Eilish O'Regan and Daniel McConnell

EMBATTLED Health Minister James Reilly's plans to introduce free GP care by 2016 seem doomed as they will require the Government to find an extra €332m.

The Irish Independent has obtained documents that show the financial mountain faced by the health service if the Coalition is to fulfil its promise on free GPs for all.

The revelations will be another major setback for Dr Reilly who is facing mounting public calls from within his own party to resign or be sacked in the wake of the mishandling of the medical card review.

And they come as the EU Commission released a devastating assessment of the health service which is already €80m over-budget for the first three months of the year.

The Commission highlighted that, despite a relatively young population, "public healthcare expenditure (in Ireland) was among the highest in the EU in 2012 at 8.7pc".

It said the challenges faced by the Department of Health were "multi-faceted" and heavily criticised the financial management and accounting systems.

"This causes delays and hurdles in collecting and processing information. It also hinders the monitoring of healthcare expenditure and efforts to achieve value-for-money and an appropriate allocation of resources," the report states.

One of Dr Reilly's key reforms now appears in serious jeopardy after internal costings were released on foot of a Freedom of Information request.

The Government has pledged that the entire population will not have to pay to see their GP by 2016 – a deadline Dr Reilly has consistently said will be met. But the huge bill makes it increasingly unlikely that 2016 deadline will be achieved, leaving the Coalition entering into a general election where it will have to explain its failure to an angry electorate.

It has still to meet the last Budget's promise to provide free GP care to all children under six, for which €37m was allocated, with the intention of starting it in July.


The documents reveal that the minister and his advisers also have to compromise on this initial rollout of free GP care. They sought costings before the last Budget on giving free GP care to all children under nine but they had to settle for the under-sixes instead.

The €332m is the additional cost which covers around 2.6 million people who are current private patients and pay for their own GP visits.

Around 1.8 million others already have cover through a medical card or a GP visit card that entitles them to free GP visits.

The highest portion of the €332m cost would be more than €222m which the HSE would pay GPs in the form of an annual capitation fee for each patient. But these sums are bad news for GPs as they are based on the payment of around €75 a year per patient – the same as they already get for each of their medical card holders.

GPs have already denounced these fees as inadequate and say they have plunged several practices into serious financial difficulty. The fee would not compensate them fully for the loss of their private fees.

The average cost of a private visit to a GP is now around €60. Their fees would come entirely from the State if free care for all was introduced.

The rest of the money is broken down into the additional practice support grants which the GPs will have to be paid as well as extras such as out-of-hours payments.

The Irish Medical Organisation (IMO) has warned that extending free GP care to the under-sixes will result in more visits and the same would be true if it included the entire population.

Talks have yet to take place on the terms and conditions of the new contract that GPs are to be offered for the under-sixes, delaying its introduction.

Irish Independent

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