- Over half (57.6%) of the population in Ireland are not currently eligible for free GP access.
- New research estimates the extra cost to extend free GP access to the entire population by 2026 would range from €381m to €881m.
- Lord Kilclooney stated the cost would be £880m, putting the amount in pounds, rather than Euros.
- At the time of the claim, £1 was worth around €1.13, making his stated claim incorrect – although the 880m figure itself did not appear from nowhere.
On 17 January, crossbench peer Lord Kilclooney claimed:
“To provide free GP care in the Republic of Ireland, which already exists in NI as it is part of the UK, would cost the Dublin Exchequer an extra £880 million!!”
Research published earlier this month estimated the maximum cost for extending free GP access to everyone in the Republic of Ireland at €881m.
At that time, the exchange rate was around 1 GBP = 1.13 EUR, meaning that Lord Kilclooney’s claim – that the cost would be £880m – higher than that maximum estimate.
Stating the wrong currency is a simple error but, in this case, also a significant one.
In the Republic of Ireland, members of the public are usually charged a fee for visiting a GP. There is no fixed price for this service, which tends to cost between €40 and €70.
However, there are many exemptions which leave people entitled to appointments with no fee. Medical card holders or anyone with a GP visit card receive free access to primary care.
The latest ‘Health in Ireland’ report indicated that in 2020 42.4% of the population in Ireland had either a medical card or GP visit card. The remainder of the population largely pay out of pocket for GP and other primary care services.
Earlier this month [Jan 2023], the Economic and Social Research Institute (ESRI) published a report called Extending eligibility for general practitioner care in Ireland: cost implications, a piece of research aiming to estimate the demand and cost implications of extending free GP services to the whole population.
Projecting these costs depends on many factors, including population size, population health, GP visit rates, the method for rolling out eligibility, and more.
The researchers modelled a variety of scenarios to provide a range of projections – including under low-, medium- and high-pressure scenarios, and using both age-based and income-based methods of extending eligibility. They concluded:
“The projected cost to the State in 2026 of extending eligibility to free GP care to the total population was estimated to range between €462 million and €881 million using the age-based approach and €381 million to €881 million using the income based approach.”
Figure 1 – source: ESRI
Leaving aside his currency error (using pounds instead of Euros), Lord Kilclooney’s claim reflects the maximum projected cost to the Irish state by 2026, if policymakers chose to extend free GP appointments to the whole population. The figure of €881m is at the top end of these projections. The research also says that extending eligibility could cost less than half that amount, to a minimum of €380.5m.
On January 17, the value of €1 moved between £0.88868 and £0.87787. Even at their closest point, at the time of Lord Kilclooney’s claim, £880m was worth €990m, which is over €100m more than the highest cost projection from the ESRI research.
The above estimates only reflect costs for extending eligibility to people who are not currently entitled to visit the GP for no fee. It does not include any costs in relation to people who already receive free primary care.
The same ESRI report estimates that the cost of providing free GP access in 2026 to those with existing entitlement will cost the State between €779.1m and €1,057.6m.
Lord Kilclooney’s claim also stated that free GP care “already exists in NI as it is part of the UK”. While usage of GP services in NI is free at the point of access, delivery of the service represents a cost to the public purse.
Government statistics highlight that in 2021/22 payments to GP’s through NI Health Trusts totalled £342.7m, equating to a cost of £169 per registered patient. While these figures are not directly comparable to the cost estimates of GP access in Ireland, it should be acknowledged that GP services represent a significant cost to the taxpayer in both jurisdictions.