2026-04-21

121. Deputy Joe Neville asked the Minister for Health if her Department has considered introducing initiatives such as a refundable tax for set-up costs on new GP practices to address the current GP shortage and incentivise more GPs to open practices; and if she will make a statement on the matter. [28453/26]

I ask the Minister if her Department has considered introducing initiatives such as refundable tax credits on costs of new GP practices or extensions to GP practices to try to address the current GP shortage and incentivise more GPs to extend their practices; and if she will make a statement on the matter.

I thank the Deputy for his question. He has highlighted this in the context of the difficulty in new GP practices opening in his area. The region has had very significant population growth but not a corresponding rise in the number of GPs available for either GMS or private patients and I acknowledge that. I also acknowledge the efforts the Deputy is trying to highlight as to what we can do to support GPs to expand their existing practices and to open new practices. That is a very fair question because everybody in this House wants more GP practices to be able to be opened. It is important for me to say that the State - I think people forget this sometimes - provides a significant level of financial support to GP practices. We work in partnership with GP practices both within the GMS scheme and more broadly. Among the more notable supports available are practice staff supports and subsidies towards the employment of a practice nurse, an administrator or a practice manager. The 2023 GP agreement increased the rates of those subsidies and introduced further staff supports. Specific supports are available for rural practices and, since 2019, in urban areas of disadvantage. The strategic review of general practice, which is currently under way, is examining the ways in which this can be better and differently supported. We have reached agreements with GPs, for example, on chronic disease management, all of which is really improving people's outcomes. It is a different way of delivering care but it is also a financial partnership with GPs. In relation to the Deputy's specific question about refundable tax for setting up new GP practices, that would be a budgetary matter for the Tánaiste and Minister for Finance, but I assure Deputy Neville that I will raise it with the Minister. I know he would like to see greater GP practices around the country, and this is certainly something I have heard from GPs that would be helpful.

I thank the Minister for her very positive reply. This has an impact especially in my constituency of Kildare North, where we see a huge need for more GPs, but I have also been very aware that it is not just commuter belt areas where we have this issue. There are also areas where there are rural sustainability challenges and indeed urban deprivation strategies. Analysis shows that it is in those three areas that we have the biggest issues. For the rural areas we have put in place a rural practice grant. For the deprived areas we have a deprivation grant. However, the one thing we have not really focused on as much is the need to help the GPs in the commuter belt. I look at the town of Maynooth. It had five GP practices 15 years ago. The population has expanded probably from about 11,000 to closer to 17,000. It now has only four GPs. That is why I am really focused on this for the commuter belt area. Maynooth is just a mirror image of what I see across the constituency.

The supports for newly establishing GPs are an important part of the strategic review of general practice, as surveys by the Irish College of General Practitioners have shown that concerns about the costs and risks of opening new practices are important considerations. Essentially, it is a matter of establishing a business and that is a challenging thing to do. Whatever about new practices, however, we also have to think about how existing practices, which might make it easier for a new GP rather than having to establish their own practice and their own business, could work more easily within the capacity of an existing practice and how that can be expanded through the addition of better or bigger premises or through the use of satellite surgeries to enable local access. The exact nature of these supports has not been finalised but it is under consideration. This could include supports with business education and training, provision of subsidies or grants, and potentially through the taxation system, as I have highlighted, subject to consultation with the Minister for Finance. Then there is also the growing network of primary care centres, from which GPs can practice. That is a really important part as well that may be complementary.

There is a lot of information in the Minister's reply and I will take on a couple of the points. I have seen the benefit of the new primary healthcare centre in Celbridge, and we have one in Kilcock. It is about maximising the outputs we can get there. I am very conscious as well that in areas like Maynooth - and this is something we have mirrored all across the country - we might have seen a GP practice in the middle of a housing estate. That would have been very common years ago. Now the new GPs may be unwilling. Will they be able to set up a practice? Will they get planning permission? These are all serious complexities for those people. Extensions, as the Minister said, are really important. If we could get those extensions, that would be phenomenal because we could have more GP services, and it is probably easier. At the same time, I am just offering the opportunity to look across the board because the more GPs we can get back the better. I know that GP services are working really complementarily with the Department and I get that feedback from them, but it is just about that chronic shortage we see in the commuter belt. We are putting in the housing, the wastewater and the roads, and it is just that social infrastructure of the likes of GPs to go with it.

Exactly, and it is a totally practical suggestion. We want to enable GPs to have their practice as quickly as possible. I have no view as to where they should practice necessarily. Of course, we would like to employ them into the HSE, but private practice is also so important. Whatever we can do to enable more GPs, it has come up again and again in this House, correctly, and I can point out all the new GPs that have been registered by the Medical Council, all of that work to clear the backlog of people looking to restore their practices and people looking to come to Ireland. If they do not have a place to work within the community that people can access, it is very challenging. I recall going to a GP practice. There was one or two in every big housing estate. It was a very natural thing and it was often a front room. Now it is a slightly different model, and that is true. There may be an opportunity to extend those premises. Just look at the changes we have made today, for example, in relation to planning permissions and so on and exemptions and what we are trying to do to encourage more and more use of space. This is a hugely important piece for any community. I thank the Deputy for his suggestion. We will come back to it within the Department of Health but it is also an important budgetary matter for the Minister for Finance.