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ESRI: Extending free GP care to all by 2026 could cost state up to €881 million

The research was published today by the Economic and Social Research Institute (ESRI).

EXTENDING FREE GP care to all in 2026 would cost the State between €381 million and €881 million, new research has estimated. 

The report was published today by the Economic and Social Research Institute (ESRI), and funded by the Department of Health.

The research estimates the cost of extending free GP care over time from this year to 2026.

Two main approaches were used in the research to identify the groups of people that would become eligible in each year – one based on age and the other based on income.

In the age-based approach, it is assumed that eligibility for free GP visits will be introduced in 2023 for those aged six and seven, in 2024 for those aged 50 to 69, in 2025 for those aged eight to 17 and, finally, in 2026 for those aged 18 to 49.

Under the income-based approach, it is assumed that current income thresholds for a GP visit card will be extended in 2024, 2025 and 2026 so that approximately one-third of existing non-cardholders become eligible in each year.

The analysis also used varying assumptions about population growth and ageing, take-up rates and payments to GPs.

The research estimated that there would be an additional 1.9 to 2.3 million GP visits in 2026 if free GP care is extended to all.

The projected cost to the State in 2026 of extending free GP care to all has been estimated to be €462 million to €881 million using the age-based approach and €381 million to €881 million using the income-based approach.

Higher costs are associated with higher take-up rates and payments rates for GPs, the research found.

The research outlined that introducing free GP care would reduce out-of-pocket expenditure on GP services in 2026 from an estimated €467 million to €95 million (using the age-based approach).

Back in 2017, a report called the Sláintecare Report presented a detailed vision of a better future for healthcare in Ireland. It made a series of recommendations – including the elimination of this country’s two-tier healthcare system and the removal of inpatient charges.

Sláintecare began to be implemented after that report, but progress has been slow, not least due to Covid-19 and last year’s cyber attack on the HSE’s system. In addition, a number of members of the advisory council have resigned in the past couple of years. 

“The Sláintecare report noted the need to move towards a universal health-care system for Ireland,” Dr Sheelah Connolly, lead author of the report, said.

“Increasing the number of people entitled to free GP care would help achieve this objective,” Dr Connolly said.

“However, there may not be a sufficient number of GPs available to deliver the additional visits associated with the ageing and growing population, as well as an increase in the number of people eligible for free GP care in the coming years,” she said.

“If there are not sufficient GPs to meet the additional demand for their services, then, while financial barriers to access may be removed, other barriers including long waits or no availability could hinder access, thereby undermining the universality of the system.”

Echoing these comments, Denis McCauley, chairperson of the Irish Medical Organisation’s GP committee, told The Journal that if the financial barrier is removed people will attend their GP services more frequently. 

He raised concerns about the infrastructure in place currently to allow for an increased demand in GP services. 

“Introducing a system like that is like telling everyone in Donegal they have free rail travel, and that’s great until you realise there are no railway tracks or trains in Donegal,” McCauley said. 

“So, getting everyone free GP care under the present system is that you’d have a GP card but you won’t be able to see a GP, essentially.” 

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