Extending eligibility for general practitioner care in Ireland: cost implications

Abstract

The mission of the Economic and Social Research InsStute (ESRI) is to advance evidence-based policymaking that supports economic sustainability and social progress in Ireland. ESRI researchers apply the highest standards of academic excellence to challenges facing policymakers, focusing on 12 areas of criScal importance to 21st-century Ireland.The InsStute was founded in 1960 by a group of senior civil servants led by Dr T.K. Whitaker, who idenSfied the need for independent and in-depth research analysis to provide a robust evidence base for policymaking in Ireland. Since then, the InsStute has remained commiYed to independent research and its work is free of any expressed ideology or poliScal posiSon.The InsStute publishes all research reaching the appropriate academic standard, irrespecSve of its findings or who funds the research. The quality of its research output is guaranteed by a rigorous peer-review process. ESRI researchers are experts in their fields and are commiYed to producing work that meets the highest academic standards and pracSces. The work of the InsStute is disseminated widely in books, journal arScles and reports. ESRI publicaSons are available to download, free of charge, from its website. AddiSonally, ESRI staff communicate research findings at regular conferences and seminars.The ESRI is a company limited by guarantee, answerable to its members and governed by a council comprising 14 members who represent a cross-secSon of ESRI members from academia, civil services, state agencies, businesses and civil society. The InsStute receives an annual grant-in-aid from the Department of Public Expenditure and Reform to support the scienSfic and public-interest elements of the InsStute's acSviSes; the grant accounted for an average of 30 per cent of the InsStute's income over the lifeSme of the last research strategy. The remaining funding comes from research programmes supported by government departments and agencies, public bodies and compeSSve research programmes.Further informaSon is available at www.esri.ie direcSon in compleSng this analysis. In parScular, the authors would like to thank Deirdre Coy and Tiago McCarthy from the Department of Health for their valuable insights. The authors also acknowledge the contribuSon of Anne Nolan of the ESRI. Valuable comments on the text and suggesSons for revision were provided by three anonymous reviewers. We thank all those who provided contribuSons while acknowledging that the authors bear sole responsibility for the analysis and interpretaSons presented.This report has been accepted for publica3on by the Ins3tute, which does not itself take ins3tu3onal policy posi3ons. All ESRI Research Series reports are peerreviewed prior to publica3on. The author(s) are solely responsible for the content and the views expressed.

Current and projected demand for nurses working in general practice in Ireland

“…In addition, the recent extension of GP visit cards to those aged six and seven, and to those earning less than the median income, will likely result in an increase in the demand for general practice services in the coming years. Connolly et al (2023), for example, estimated that the extension of GP visit cards to six-and seven-year-olds would result in an additional 57,571 card holders and an additional 100,000 GP visits per annum. They also estimated that extending GP visit cards to one-third of existing non-cardholders with the lowest income would result in 900,000 additional card holders and 600,000 additional GP visits; such a significant increase in the demand for GP services would likely result in an increased workload for practice nurses.…”

“…In 2019, there were an estimated 18.8 million visits among community-dwelling individuals to a General Practitioner (GP) and 5.1 million separate visits to a nurse working in general practice in Ireland (Walsh et al, 2021). While the demand for general practice services generally increases with age, general practice differs somewhat to other healthcare services as it is used across all age groups, with relatively high utilisation among children under five and females of childbearing years (Connolly et al, 2023). Reflecting a growing and ageing population, there is projected to be a significant increase in the demand for general practice services in the coming years (Walsh et al, 2021).…”

“…Population growth and ageing, as well as reform proposals which seek to incentivise the greater delivery of care in primary and community settings, will result in an increase in the demand for general practice services in the coming years (Walsh et al, 2021;Connolly et al, 2023). While much of the focus to date has been on the increasing need for GPs, there will also be an increasing demand for practice nurses given (as shown in the previous chapter) the increased utilisation of nurse services among older people and those with chronic conditions.…”

Improving access to healthcare in Ireland: an implementation failure

“…In Ireland, a growing and ageing population will contribute to significant increases in the demand for a range of health care services in the coming years (Wren et al, 2017), and with it significant increases in health care expenditure (Keegan et al, 2020;. Recent Irish analysis, for example, estimated that the cost of extending eligibility for GP care that is free at the point of use to the whole population would be between €462 and €881 million in 2026 (Connolly et al, 2023). Even if the financial resources were available to meet this cost, the question arises as to whether there would be a sufficient number of GPs available to deliver the additional demand associated with an ageing and growing population, as well as the increase associated with a further extension of eligibility (Connolly et al, 2023).…”

Primary care clinicians’ perspectives on interacting with patients with gynaecological conditions: a systematic review

“…1 , 12 , 13 The WHSE sets out measures to improve treatment and support for gynaecological conditions as a matter of high priority. 3 What is less well-known is whether PCCs perceive that there are challenges around interacting with patients with gynaecological conditions and symptoms. However, there is an emerging body of qualitative research that explores the challenges of diagnosis and management for this patient group, within which data on listening to and interacting with patients are reported.…”