For immediate release 10th October 2018

Reaction to Budget 2019

  • Budget 2019 will result in “Death by 100,000 cuts” for General Practice
  • The GP union says 100,000 GP visit cards issued without consultation, negotiation or discussion will have a devastating impact on the delivery of patient care.
  • NAGP recommends that GPs should, if necessary, close their lists to all new patients, in order to provide existing patients with the safe care they deserve and expect.

The National Association of General Practitioners (NAGP) is advising its 2,100 members to honour their contracts – something that the Government and the Department of Health have repeatedly failed to do. This may mean that GPs do not carry out any work outside of the contract.

Working to contract will mean that, unless it is safe to do so, GPs may not take on any new patients. In recent weeks, it has become clear that the Government does not intend to reverse FEMPI cuts for General Practice. This is an untenable situation and GPs cannot support a failing health system any longer.

The original GP contract is over 40 years old and is not fit for a modern, family doctor service.

Patient safety is at the heart of this issue and with GPs under increasing pressure, there is no logic to taking on additional work, particularly if there are insufficient resources to do so safely.

GPs have been expected to care for an increasing number of medical card and GP visit card patients over the past ten years.

General Practice receives €42.50 in total per year, per medical card. This is for unlimited GP visits. The practice carries all expenses relating to the provision of patient care, including nurse & secretarial salaries, insurance, utilities, equipment, phone charges.

There are now approximately two million patients with a medical card or GP visit card – a 40% increase in five years. General Practitioners are struggling to manage with the drastically reduced funding. Now it is proposed to increase patient numbers by a further 5%. This is unsustainable.

Over the last eight years General Practice has suffered a reduction of practice funding and resources of 38% under the Financial Emergency Measures in the Public Interest (FEMPI) while practice costs and expenses continue to rise.

The NAGP is recommending that its members simply work to contract, in the interests of the health and safety of both patients and its GP members.

Dr Andy Jordan, NAGP Chairman said: “Recent commentary from the HSE and Government representatives about their aspirations to unwind FEMPI at some undetermined time in the future is meaningless. Many GPs are burnt out and many more will simply resign or drastically reduce their GMS practices.

“All stakeholders agree that a cornerstone of healthcare reform in Ireland must be a move to more community-based care. This requires resourcing. What this budget means to General Practice is ‘Death by 100,000 cuts’.

This budget does nothing to eradicate the mass immigration of our highly qualified GP trainees. It does nothing to encourage our GPs to return home. It does nothing to enable patients to find a General Practitioner.”

Government Ministers have made repeated promises and given undertakings that they have failed to honour. The time has finally come to call out the political rhetoric employed by the current Minister for Health. Patient safety is of utmost concern to our members, so we are recommending that, if necessary, GPs close their lists to all new patients and give their existing patients the safe care and service they deserve, require and expect.


  • With almost 700 GPs due to retire in the next three to five years,
  • Majority of GP Trainees are emigrating,
  • We are experiencing increasing numbers of unfilled GP posts around the country, and rural General Practice is no longer viable.
  • Patients with medical and GP Visit cards have increased to a half of the population in recent years with the introduction of the under 6’s and over 70’s free GP care.
  • 74% of GP General Medical Service (GMS) lists are now closed to new patients.
  • Over the last decade, €1.5bn of resourcing has been stripped from General Practice and replaced with more GMS and Doctor Visit Cards but without commensurate increases in funding for same.