Our 2010 study 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 way the General Medical Services (GMS) contracts for GPs operated. The system favoured existing GP practices and protected them from competition from newly-qualified GPs. GPs were restricted in how they advertised and hospital doctors faced unnecessary restriction in transferring to private GP practice.
We made seven recommendations to address these 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.
The Act provides that:
GMS contracts are now open to all fully qualified and trained GPs
GPs are free to establish a practice and treat public patients in any part of the country
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’s Guide to Professional Conduct significantly eased restrictions on advertising by GPs. 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 obtaining a GP qualification (MICGP qualification). The programme is aimed at doctors currently working in general practice in Ireland who have not undergone accredited training in general practice and who wish to apply for inclusion on the specialist register of the Medical Council.