General Medical Practitioners (“GPs”)

The Competition Authority found restrictions on competition among GPs in Ireland that affect both public and private patients. These restrictions mean that patients have fewer GP practices to choose from. There is less pressure on GP practices to compete on price for private patients, or to be innovative in the services they provide.

We made seven recommendations for change, in the following three areas:
1. General Medical Services (“GMS”) Contract for GPs (5 recommendations)
2. Advertising (1 recommendation)
3. GP Training Programmes (1 recommendation)

1. General Medical Services (“GMS”) Contracts for GPs:
Our Report identified serious problems with the General Medical Services (“GMS”) contract for GPs. We found that the current GMS system favours existing GP practices and protects them from competition from newly-qualified GPs.

In September 2011, the Department of Health published a Bill designed to remove restrictions on GPs who wish to treat public patients (See Health (Provision of General Practitioner Services) Bill 2011).The Bill gives effect to a commitment in the EU/IMF Programme for Ireland. The new Bill will implement four of our key recommendations. It will help to ensure greater access to GP services and better quality and services for all patients (See TCA press release 15/9/11).

The Bill provides that:
• Access to GMS contracts will be open to all fully qualified and trained GPs;
• GPs will be free to establish a practice and treat public patients in the location of their choice;
• The viability of existing GP practices in an area will no longer be a factor in awarding GMS contracts;
• GPs who received a GMS contract under the 2009 interim entry provisions will be free to accept any patient who chooses to attend them, including existing medical card holders who wish to transfer from another practice; and,
• Time limits which currently exist in relation to the dissolution of GP partnerships will be abolished.

2. Advertising:
Until recently, advertising by GPs was severely restricted. In November 2009, the Medical Council significantly eased the restrictions on advertising by GPs, following submissions by the Competition Authority (See Medical Council Guidelines 2009).

3. GP Training:
Doctors who have completed relevant hospital-based training, and who subsequently receive a place on a GP training programme, must repeat training they have already completed. Under the EU/IMF Programme, the Government has committed to addressing this problem.

Updated:  November 2011
Further information:
Deirdre Mc Hugh
dmch@tca.ie
01-8045466