General Medical Practitioners (GPs)
Our 2010 Report on General Medical Practitioners found a number of restrictions on competition among GPs in Ireland. These made it difficult for newly-established GPs to set up in practice and meant that public and private patients had fewer GP practices to choose from. This in turn meant that GP practices were under less pressure to compete on price for private patients, or to be innovative in the services they provide.
We found serious problems with the manner in which the General Medical Services (GMS) contracts for GPs operated. The system favoured existing GP practices and protected them from competition from newly-qualified GPs. We also found problems with regard to advertising by GPs (which was, until 2009, severely restricted) and with aspects of the GP training programme (which required doctors who had completed relevant hospital-based training, and who subsequently received a place on a GP training programme, to repeat training they had already completed).
We made seven recommendations for change to address the above problems.
All of our recommendations for change have now been acted on.
In March 2012, the Government passed the Health (Provision of General Practitioner Services) Act which removed restrictions on GPs who wish to treat public patients (http://www.irishstatutebook.ie/2012/en/act/pub/0004/index.html).
The Act provides that:
Access to GMS contracts is now open to all fully qualified and trained GPs.
GPs are free to establish a practice and treat public patients in the location of their choice.
The viability of existing GP practices in an area is no longer a factor in awarding GMS contracts.
GPs who received a GMS contract under the 2009 interim entry provisions are free to accept any patient who chooses to attend them, including existing medical card holders who wish to transfer from another practice.
Time limits which previously existed in relation to the dissolution of GP partnerships have been abolished.
By November 2012, 97 GPs had been granted a GMS contract under the new scheme and a further 33 applications were being processed.
In November 2009, the Medical Council significantly eased restrictions on advertising by GPs (http://www.medicalcouncil.ie/Public-Information/Professional-Conduct-Ethics/The-Guide-to-Professional-Conduct-and-Ethics-for-Registered-Medical-Practitioners.pdf). The Irish Medical Organisation now recommends that all doctors display price lists.
The Irish College of General Practitioners (ICGP) has developed an Alternative Route to MICGP qualification. The programme is aimed at doctors currently working in general practice in Ireland, but who do not meet the criteria for inclusion on the specialist register of the Medical Council. Applications for this programme are due to open in April 2013.
Updated February 2013
Further information: Deirdre McHugh