Brian Stanley warns of GP shortage and urges salaried GPs
Brian Stanley warned that the country's primary care system is strained by GP shortages and inequitable access, and he urged the government to introduce salaried GPs, increase training places, expand free GP care and build new primary care centres. He said immediate action is needed to prevent delayed diagnoses, rising hospital admissions and growing pressure on acute services.
Primary care crisis and GP ratios
Brian Stanley cited World Health Organization guidance that there should be one GP per 1,000 people. He said County Leash has one GP per 1,700 (about just over 60 practising at any one time) and South Leash has one per 2,300, with populations continuing to rise and access becoming increasingly problematic.
Medical card threshold and cost barriers
He warned that cost can be a barrier for many working class and low-income households who do not have a medical card. He highlighted an income threshold figure of 186 euros that excludes people from a medical card and said that same figure has not changed for more than two decades, leaving some families unable to afford GP care and pushing patients into hospital with more complex illnesses.
Calls for salaried GPs and expanded training
Stanley welcomed proposals from the Social Democrats and urged a move away from sole reliance on private GP practices. He said most GPs are overworked, newly qualified doctors fear setting up private practices due to overheads and long hours, and the country lacks salaried GPs working in HSE primary care community centres like other EU countries. He called for a scheme to directly employ salaried GPs and for increased GP training places and facilities.
Targets, services and premises
He recalled a care plan agreed nine years ago that promised free universal primary care within five years but said progress has been at "glacier pace". He urged the minister and HSE to set a target date for full implementation, expand primary care services to include occupational therapy, physiotherapy, speech and language, mental health services and diagnostics, and deliver new or vastly expanded health centres in Grey Cullen, Rathdowney and Mount Trat and a new primary care centre in Portlaoise. He argued improved primary care would reduce demand on A&E and nursing homes and lead to a more efficient health system.
We publish thousands of recordings to make Irish politics transparent and resistant to manipulation. Spotted an error? Report it — together we are building a reliable archive of Irish politics.
Thanks, Cairlock, and I want to welcome these proposals from the Social Democrats. It's very timely. I think we have to accept that the bedrock of any health system is having a good primary care in place. And to have good primary care, you need GPs. But the ratio of GPs in this country is completely out of kilter with what it should be. World Health Organization says that there should be one GP per thousand of population. In County Leash, we have one per 1,700 population. There's about just over 60 practising at any one time. In South Leash, the ratio is one per 2,300. And the population in the county continues to rise. The impact of this, of course, is obvious. You know, while existing GPs do good work, etc., access is problematic. People are not getting their diagnosis in time. People are not getting the treatment that they need in some cases. And patients develop more complex medical problems and then they have to go to hospital. Cost can be a barrier for some, as a large number of working class and low-income households don't have a medical card and may not be able to afford it. Some practices can't accept new clients. And on the Income Threshold Minister, again after the budget, you know, the booklet comes out in terms of entitlements. And it's 186 euros. If you're on more than 186 euros a single person, you can't have a medical card. You know, this is the year 2026. That's the same figure for more than two decades. I can't understand why that hasn't changed. We have a reliance on private businesses, GPs, and that's fine. A lot of them are doing very good work. Most of them are doing very good work. In fact, they're overworked. But we're the odd one out in the European Union because we don't have salaried GPs working in primary care community centres owned by the Health Service Executive like other countries have. So young, newly qualified GPs, most of them don't want to set up a GP practice because they need apprentices. They need staff. They need insurance, administration, utility bills, et cetera. And then face them working into an 80-hour week for life. And that's the situation that we have. They want to work in a 9-to-5 job like everybody else. We had a slouching care plan agreed by all parties nine years ago. And central to this was free universal primary care within five years at the point of delivery. You know, everyone's agreed on that. But, you know, we're moving towards it at glacier pace. There should be a range of services provided at primary care level that should be expanded to include occupational therapy, physio, speech and language, mental health services and diagnostics and so on. So what's needed now, Minister? And I'm saying this to you. You know, we're nine years now since we agreed to launch a care. We need a determined effort by government and HSE. And I think everybody here in this house would support it to increase the number of training places for GPs, to expand those numbers and the facilities for that. And in addition to the private practices, which we have there, we accept that and they're doing good work. We need directly implied GPs. Some government ministers have talked about this in the past, but then it dies away. It's buried then. So we need salary GPs to be implied. We need a scheme established. And I'd appeal to you to try and take a lead in this as a minister in the Department of Health. You know, to work alongside others, but to be there in primary care centres, in the local HSE health centres, similar to the rest of the European Union. We need to set a target date for the full implementation of free universal primary care. Because if we don't set a target, we all know this in our own work. If we don't set targets, we don't get there. You know, so we should set a target to do that. And I know it'll be challenging. And I know we can't wait. You know, but we have to start sometime. And in the short term, you know, we should expand free GP care to all workers on or below the median wage. This is really a problem. People say to me who are working hard, you know, the children got sick. The children go to the doctor. Myself, my wife got sick. We couldn't go. We couldn't afford to go. And that's not acceptable. That that happens. Younger children, because of free GP care, can go. So the fact that we don't do that means that people are winding up in hospital with chronic illnesses. So we also need proper premises. And I'm going to say this to you as a Grey Cullen person. We need a new or vastly expanded health centre in Grey Cullen. We need the same in Rathdowney and Mount Trat. And we need the new primary care centre built in Portlaoise. And I would say as well to you, Minister, that if we improve primary care, you know, it will bring not just a healthier population, but leads the burden on acute services. Because as has been said by others, people wind up there. And I know that from staff working in the A&E in Portlaoise. And we have to start stopping the problem. It's like we're mopping up the floor and the pipe is still leaking. You know, we can deal with this at community level. Thank you, Deputy. And this would reduce the demand as well on nursing home cases. And we'd have a more efficient health system. Thank you. Thank you. Deputy.
Thank you for downloading 🙏
If you publish this material on social media, we would be very grateful if you tagged VideoParliament. It helps us reach more people and keep building a transparent archive of Irish politics.
