Universal free GP care ‘unachievable’ without huge expansion in GP numbers – ICGP

The ICGP has welcomed the publication of new ESRI research on the extension of free GP care to all in 2026. However, it warned it was “unrealistic” to expect universal free GP care by this date due to lack of GP capacity and infrastructure.

According to the College, many GP practices are already at full capacity and are unable to take on new patients. Many are also unable to find GPs to replace the retiring workforce.

Chair of the ICGP board Dr John Farrell said: “While the ICGP supports the extension of free GP care in principle, in practice this is unachievable without a huge expansion in GP numbers.”

 “We welcome the research by the ESRI which estimates that there would be an additional 1.9 to 2.3 million GP visits in 2026 if free GP care is extended to all, as this gives clarity to the demands that universal free GP care would place on general practice.”

The extension of free GP care to the under sixes in 2015 led to a 30 per cent increase in GP visits. Extending free GP care puts a large strain on daytime practices, and even more pressure on out-of-hours services.

Medical Director of the ICGP, Dr Diarmuid Quinlan, said: “We have had an exceptionally busy winter period so far, and there is no surge capacity in the system.  The ICGP is now training 70 per cent more GPs per year than it did six years ago, but we have an ageing workforce, with 25 per cent of our GPs over 60 years of age.”

He added: “We currently have over 4,000 GPs, of whom 570 are likely to retire by 2026. We need to increase the number of GPs to around 6,000 by 2028 to meet existing demand and cater for a growing population and GP retirements. Expanding free GP care will inevitably exacerbate patient waiting times to see GPs.”

The CEO of the ICGP, Mr Fintan Foy, said: “The ICGP has presented 10 workable solutions to the GP workforce crisis in our ‘Shaping the Future’ discussion document, and we urge the Minister for Health to establish a High-Level Working Group on the Future of General Practice, with all the relevant stakeholders. We cannot deal with the existing GP workforce crisis without innovative solutions, which go beyond a review of the existing contract.”

At present, there are 932 GPs in the four-year training programme, including an intake of 258 in July 2022. The College plans to increase training places to 286 in 2023 and will reach 350 by 2026.

To increase the numbers in training beyond that number requires not just more access to hospital posts, but also increased numbers studying medicine at an undergraduate level, who might then decide to do general practice specialist training.