04 Jul Expansion of Free GP Care

More than half a million more people will now benefit from Free GP Care this year.

• 500,000 additional persons, who otherwise would have attended their GP and have to pay for it, will become eligible for free GP care under this expansion.
• 78,000 children aged 6 and 7 will be entitled to free GP visits from mid-August (applications open on August 11^th).
• A further 430,000 people in households earning no more than the median income will be entitled to free GP cards in two phases – applications will open from mid-September and mid-November.
• As this is the largest expansion in eligibility for GP care without charges ever undertaken, it is necessary to phase its introduction to avoid the creation of logjams in the application process.
• This Government is committed to expand universal access to health care in a manner that is fair and affordable.
• By the end of this year well over half the population will have access to free GP care either through a GP card or a medical card.
• The full-year cost of the package agreed with the IMO, comprising payment of relevant fees and capacity supports, amounts to €130 million.

GP Care for 6- and 7-year-olds – initially signalled in Budget 2022

• Applications for cards for children aged 6 and 7 will open on August 11^th.
• Applications will be processed online on the HSE website similar to the way parents got a card for children under 6.
• The information and documents required will be the same as heretofore (PPSN, Child’s PPSN, GP Name).
• No income limits will apply for GP cards for children aged 6 and 7.

GP Care for households earning no more than the median income – Budget 2023 measure

• Applications for the first group (lower income limits) under the median-income expansion will commence on 11 September.
• Applications for the full group (higher income limits) under the median-income expansion will commence on 13 November.
• Applications will be processed online on the HSE website and the information and documents required will be the same as up to now for a GP Card / Medical Card.
• The same expenses (housing costs, transportation, etc.) as are currently set against income in Medical or GP Visit Card applications will also continue to apply.
• The types of allowable expenses you should include in your application are:
  • rent payments
  • mortgage payments
  • childcare costs
  • travel to work costs
  • maintenance payments
  • net cost of private nursing home care
  • mortgage protection premium
  • life assurance for mortgage protection
• There will be an information campaign ahead of the opening of applications to provide further information to the public.

It is important to remember that everyone’s circumstances will be different and the application process will take applicants through their own income and expenses to assess eligibility.

For illustrative purposes only the following examples show how people / families may qualify for a free GP card:

Example 1 – single person, renting, no children

	Current	New
Base threshold	304	418
Weekly rent	300	300
Allowable commuting cost	50	50
Net eligibility threshold	654	768

 

Under the old threshold, this person could earn no more than €654 per week to be eligible.  Under the new threshold, this person could earn up to €768 per week.

 

Example 2 – Couple, 2 children, with mortgage, single income

	Current	New
Base threshold	441	607
Weekly mortgage	300	300
Allowance for 2 dependents	114	114
Net eligibility threshold	755	1,021

 

Under the old threshold, this couple could have combined earnings of no more than €755 per week to be eligible.  Under the new threshold, this couple could have combined earnings of up to €1,021

 

 

 

Example 3 – Couple, 3 children, with mortgage, dual income

	Current	New
Base threshold	441	607
Weekly mortgage	300	300
Allowance for 2 dependents	114	114
Childcare	200	200
Net eligibility threshold	1,055	1,221

 

Under the old threshold, this couple could have combined earnings of no more than €1,055 per week to be eligible.  Under the new threshold, this couple could have combined earnings of up to €1,221

 

Package of Supports for GPs:

• The State paid in the region of €700 million to GPs in 2022 (just on GMS – ie those with medical cards and GP visits cards), up from €530 million (just on GMS) in 2018. That represents a 32% increase.
• In addition to the €700 million paid to GPs in 2022, they were paid an additional €71 million in Covid expenditure and other funding for vaccination programmes.
• This Agreement with the IMO includes a total financial package amounting to €130 million.
• The package is made up of:
  • Enhanced capitation rates for children aged 6 & 7, reflecting the move to a universal service for this age group;
  • Enhanced capitation rates for other children up to the age of 12 to bring them into line with the fees for children aged 6 & 7;
  • An increase of 10% in the capitation rates payable for patients aged from 13 to 69 years of age;
  • Capacity supports to enable the expansion and retention of staffing within general practice;
  • Additional support for the GP Out of Hours services; and
  • Improvements in payments relating to the provision of contraception services under the GMS.
• The agreement also includes provision to permit the expansion of the Chronic Disease Management Programme to include hypertension and women who suffered from gestational diabetes and pre-eclampsia.
• The 2023 Agreement with the IMO provides a package worth €30 million specifically to support capacity in general practice.
• It will permit GPs to retain staff and recruit additional staff to meet demand.
• There will also be additional support of €2 million to support the GP Out of Hours services.

Increasing the number of GPs

• The number of GPs entering training has more than doubled from 120 in 2009 to 258 in 2022, with 285 places available this year.
• Working with the ICGP, 350 GP training places will be available for new entrants next year (2024).
• The ICGP have stated that the number of GP training graduates emigrating has been decreasing since 2017, with less than 6% of GPs emigrating as per their latest graduate survey.
• The Minister has in addition supported the ICGP non-EU doctors programme which will bring up to 100 GPs to Ireland this year and up to 250 next year in an accelerated adaptation programme.

Strategic Review of general practice

• The Minister for Health on 3rd April published the Terms of Reference for the Strategic Review of General Practice. The review, with stakeholder input, will examine the broad range of issues affecting general practice, and will set out the measures necessary to deliver a sustainable general practice. Work on the review has commenced and is intended to be completed this year.