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General Medical Practitioners

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The Competition Authority found that Ireland was facing a shortage of GP services and that people were delaying GP visits because the cost of a GP visit has risen much faster than inflation.  The report was published in three parts; parts I and II were published in December 2009, with the third part of the report published in July 2010.

Three factors are harming patient choice and competition for patients:
1. Restrictions on the number of qualifying GPs;
2. Restrictions on advertising by GPs; and
3. Restrictions on GPs wishing to treat public patients.

The reports identified solutions to improve access to GP services, to improve consumer information on GP services (including information on prices) and to remove barriers to new GPs establishing new GP practices.

Training

A bottleneck in GP training contributes to the shortage of GP services.  To ease future shortages in GP services, we recommended a fast-track GP training course for doctors with relevant hospital training and experience.  This will result in more GPs being trained as quickly and as cheaply as possible.

The Irish Colleage of General Practitioners agreed with the Authority and is currently discussing funding for this fast-track process with the Health Service Executive (HSE).

Advertising

Traditionally, GPs were not allowed to advertise.  The Medical Council accepted our recommendation to remove unnecessary restrictions on truthful and informative advertising.

GPs are now free to advertise their services and prices if they wish.  For example, a new GP practice can now distribute leaflets advertising their services and prices.  If GPs do this, patients should start to see more information about the services available to them and how much they can expect to pay.

General Medical Services (GMS) system

Competition between GP practices is restricted by certain features of the GMS system for subsidised GP services.

A GMS contract is very valuable to a GP practice; very few GP practices operate without one.  The GMS system favours existing GP practices and protects them from competition from newly-qualified GPs.  This limits the number of GP practices in Ireland.

Acces to GMS contracts should be opened up to all qualified GPs.  The aspects of the GMS system that protect existing practices should be removed.  For example, GMS contracts should not be withheld in case the new practice will affect the viability of a neighbouring practice.

We also recommend that payments to GPs under the GMS should not be decided on the basis of agreement with the Irish Medical Organisation (IMO), but should be decided by the Minister for Health and Children, following consultation with GPs, and the IMO, if desired.

These changes can help contribute to the overall improvement and availability of GP services, resulting in benefits to all patients, public and private, and the State.


Date Printed: 10 September 2010

© The Competition Authority 2010