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Recent tweets have highlighted some confusion about general practice funding in Ireland so I hope this thread helps.
1.This is how Irish general practice is funded and what it does. Talk to your TD about #SaveGP
1.This is how Irish general practice is funded and what it does. Talk to your TD about #SaveGP
2. Irish general practices are independent businesses run by GPs who employ a range of staff to support delivery of care. They are mainly funded through a range of state contracts including the General Medical Services (medical cards) and some additional services
3. These services include childhood immunisations, antenatal care , diabetes care, cervical screening and some additional specified services including out of hours visits. Patients not eligible for these pay a fee of between €45 and 70 per visit (tax deductible if working)
4. Approximately 40% of patients are covered by the GMS. Eligibility is based on income. For a full medical card a single person under age 66 living alone qualifies if gross income is under €184 weekly. Eligibility rates vary
https://www.citizensinformation.ie/en/health/medical_cards_and_gp_visit_cards/medical_card_means_test_under_70s.html">https://www.citizensinformation.ie/en/health...
https://www.citizensinformation.ie/en/health/medical_cards_and_gp_visit_cards/medical_card_means_test_under_70s.html">https://www.citizensinformation.ie/en/health...
5. The general practice receives an annual fee per person (capitation) that varies by age and gender. Capitation varies from €43- €271 per year. Doctor visit cards have a higher income threshold and are also given to all children under 6 (regardless of family income)
6. We don’t have good information on how many GP visits people make every year but different studies have suggested average rates of between 4 and 11 visits a year depending on age and socioeconomic status. People with chronic conditions have higher visit rates
7. For GMS eligible patients the average visit rate is 7. So, for an average middle aged person with a medical card the practice receives an annual capitation fee of approximately €100 meaning an average practice income of €14 per visit.
8. Just to be clear, these fees are practice based income and pay for everything. GP partners running practices take their income after all other running costs deducted. Currently, publicly funded general practice is only viable with income from other sources and services
9. There is also no recognition that people with more health problems require more healthcare with no extra resources available for GP in the most disadvantaged communities despite higher death rates and earlier development chronic conditions http://www.deepend.ie"> http://www.deepend.ie
10. Meanwhile, general practice gets about 3-4% of the annual health budget in Ireland compared to 8-9% in the UK. And yet we know that better primary care and continuity of care with the same doctor improves health outcomes and reduces high cost events like hospitalisation
11. GPs see between 20-30 patients daily with additional emergency appointments, house visits, phone calls and repeat prescriptions adding to workload. They have the privilege of knowing their patients over years building relationships that protect health.
12. #Slaintecare recommends that GP should be free at the point of delivery for all patients (as in many other European countries). This doesn’t mean it is free – still paid for through taxation. To deliver this we need to prioritise and fund general practice
13. Irish general practice is in crisis following years of under investment and emergency recession cuts of up to 38%. Many parts of Ireland no longer have GPs that can take on new patients. If you want a functioning general practice system in Ireland – let your TD know #SaveGP
