The following motion was moved by Deputy Pádraig Rice on Wednesday, 25 February 2026:
That Dáil Éireann:
recognises that:
— access to timely General Practitioner (GP) care is a fundamental pillar of a safe, effective and equitable health service;
— GPs play a vital role in our health service, managing the majority of people's medical care needs, and acting as the first point of medical contact for most patients;
— GPs provide a core leadership role in delivering care outside of the hospital setting, and are central to the provision of Sláintecare's new model of integrated, multidisciplinary care; and
— to continue the shift away from our current hospital-centric system, patients must have timely access to GP and community-based healthcare services that are free at the point of use;
notes that:
— Ireland is an outlier in Europe in not providing universal primary healthcare that is free at the point of need, instead, we have a system of eligibility which is determined primarily on the grounds of income or age;
— according to the Health Service Executive (HSE) Primary Care Reimbursement Scheme, approximately 42 per cent of the population has access to free GP care through medical cards or GP visit cards, and the remaining 58 per cent pay out of their own pocket;
— the cost of visiting a GP can range from €50 to €90;
— in 2025, research commissioned by the Irish Cancer Society found that more than 30 per cent of people surveyed didn't attend a healthcare appointment because of cost;
— the same survey revealed that 25 per cent of people prioritised other costs over their healthcare, including heating and eating;
— a key recommendation from the Oireachtas Special Committee on the Future of Healthcare Sláintecare Report, published in 2017, was universal GP coverage by year five of implementation;
— the 2016 Programme for Government committed to extending free GP care to under 18s, which never happened;
— free GP care for children aged under six was rolled out in 2015, but it took another eight years before free GP care for children under eight was authorised in 2023; and
— the 2025 Programme for Government commits to extending free GP care to children up to at least 12 years;
further notes that:
— the 2017 Sláintecare Report stated that the current GP contract was a barrier to a primary-care orientated health service, and recommended an entirely new contract to facilitate new ways of working;
— the current GP contract is over 50 years old, and although it has been amended on numerous occasions, the core contract does not reflect modern day general practice, nor the future career expectations of young trainees and GPs;
— research carried out by the Irish College of GPs in 2023, found that almost half of trainees, 48.1 per cent, were not prepared to take up the contract within a year of finishing their training;
— the same research found that just above one third, 36.7 per cent, of graduates felt comfortable with the traditional responsibilities of the GP principal/partner position;
— the need for better working conditions, greater flexibility and new ways of working has consistently been identified by the Irish College of GPs and the Royal College of Surgeons in Ireland, in their GP Retention Project; and
— in April 2023, the Department of Health and the HSE initiated a Strategic Review of General Practice, which was due to be completed that year but is still ongoing, nearly three years later;
acknowledges that:
— according to the Economic and Social Research Institute, an additional 943 to 1,211 GPs will be needed by 2040;
— while the Irish College of GPs estimates that 2,000 more GPs are needed due to current demand of our aging population and population growth;
— in 2024, just two counties exceeded the World Health Organization's recommended ratio of 100 GPs per 100,000 of population, with areas of deprivation and rural areas worst served;
— it is well established that there are higher and more complex health needs in areas of deprivation, yet there are fewer GPs working in these communities compared to more affluent areas;
— it is estimated that Dublin's North Inner City has one GP for every 3,525 people, compared to the national average of one GP for 1,759 people; and
— a third of the population lives in rural Ireland, yet the Irish College of GPs estimates that only 10 per cent of GPs work in these areas, with many in solo practices;
further acknowledges that:
— the Chronic Disease Management Programme (CDMP) has clearly demonstrated what general practice can deliver, when structural programmes, which align with Sláintecare, are implemented and resourced; and
— last year, the HSE's report on GP-led Chronic Disease Management found that participants in the programme had 30 per cent fewer emergency department attendances, 26 per cent fewer hospital admissions, and 33 per cent fewer GP out-of-hours visits;
is concerned that:
— many GPs are overworked, burnt-out and increasingly overburdened with administrative work, all at the expense of their own work-life balance;
— in the absence of reform, we are seeing the increasing corporatisation of general practice, with small family practices being bought up by investor-owned corporate entities with multiple locations;
— a significant number of GPs are approaching retirement, with the Irish College of GPs estimating that 600 GPs are aged 65 or over, 300 of whom are aged 65 to 69, and 300 of whom are still working aged 70 and over;
— according to an Irish Independent survey of 275 registered GPs carried out in 2024, more than half of the GPs could not accept new patients, with more than two out of three GPs in rural Ireland unable to take on new patients; and
— there are critical gaps in out-of-hours GP services, and capacity constraints in daytime general practice are putting additional pressure on out-of-hours services; and
calls on the Government to:
— in the forthcoming budget, implement the Programme for Government commitment to expand free GP care to children up to 12 years of age;
— immediately set out a clear timeline for the delivery of universal GP and primary care, which is free at the point of use, within the lifetime of this Government;
— introduce a salaried GP model, with GPs directly employed by the HSE, for underserved communities, beginning with rural areas and offshore islands, and expanding into areas of deprivation and out-of-hours services;
— create a new DEIS for GPs scheme, deprivation-weighted General Medical Services capitation rates, with a cap on list size, in recognition of the additional health needs of patients in deprived areas;
— expand locum cover supports for GPs, by developing a nationwide HSE locum bank to ensure all GPs can take leave;
— develop a new GP contract which facilitates new ways of working, meets the work-life balance and career expectations of younger GPs and trainees, and incentivises health promotion, public health work, disease prevention, and the delivery of integrated care;
— invest in a national GP Clinical Lead role, to design, test and support new models of rural and remote general practice care;
— establish a primary care health equity working group, with representation from frontline services and patients living in deprived areas, similar to the successful Scottish model;
— accelerate the delivery of HSE-built primary care centres, to provide suitable premises for GPs and their teams, and support the delivery of integrated, multidisciplinary care;
— develop a national strategy to attract, support and retain future GPs, and this should include increased exposure to general practice in medical schools, structured post-training fellowships, specific time spent in practices in both rural areas and areas of deprivation during GP training, and measures to support more diverse, flexible, and equitable career pathways;
— accelerate implementation of the Irish College of GPs' 2023 report, entitled "Medical Student to General Practitioner - An urgent call to action";
— provide an additional 100 GP training places, through the expansion of training capacity in hospitals and supporting training practices;
— implement a new model of out-of-hours GP care, which is uniform across the country, to ensure that access to out-of-hours care is consistent;
— align general practice nurses' terms and conditions with their HSE colleagues, recognise and support general practice nurses' continuing professional development, and establish clear career pathways for progression;
— increase annual public health nurse training capacity, from 160 to 240 places;
— remove the Common Conditions Service fee for medical card holders;
— provide universal access to the CDMP for all patients with type 2 diabetes, asthma, chronic obstructive pulmonary disease, cardiovascular disease and any further expansions such as the planned inclusion of chronic kidney disease;
— expand the CDMP to include severe and enduring mental health difficulties, epilepsy and other conditions as appropriate, in consultation with GPs delivering the service;
— develop a structured women's health programme for general practice, which deals with contraception, screening of STIs, fertility, pre-conception, endometriosis and menopause; and
— develop a national GP data framework to provide for integration with future eHealth systems, standardised data collection, greater data flow, data stewardship and investment in analytical capacity.
Debate resumed on amendment No. 1:
To insert the following after "and investment in analytical capacity":
";
further recognises that:
— the inverse care law and unequal access to GPs is giving rise to stark inequalities, delayed diagnosis, poorer health outcomes, and increasing upward pressure on the hospital system;
— recent extensive research by the Labour Party on GP-to-patient ratios has highlighted significant inequalities, and found that there is one GP per 1,390 of population in Clontarf in Dublin 3, yet in Cabra in Dublin 7, the ratio is one GP to 3,060 of population;
— suburban areas of significant population growth are struggling with a lack of GP services, with East Meath having one General Medical Service GP for every 5,090 people, a divergence of 3,331 from the national average; and
— the 2025 Economic and Social Research Institute projections, of national demand and workforce requirements for general practice in Ireland, also show there will be a demand increase of at least 23 per cent by 2040, requiring up to an additional 761 to 868 General Practice Nurses, alongside increased GP numbers; and
therefore, further calls on Government to support the passage into law of the Health (Availability of General Practitioner Services) Bill 2025, to provide for a direct statutory link between the HSE's assessment of the level of need for primary care services in specific areas, and the level of service provided.".
- (Deputy Marie Sherlock)
I must now deal with a postponed division relating to the motion regarding expanding access to general practitioner care. On Wednesday, 25 February 2026, on the question, "That the amendment to the motion be agreed to", a division was claimed and in accordance with Standing Order 85(2), that division must be taken now.
Amendment put:
The Dáil divided: Tá, 65; Níl, 76; Staon, 0.
Tellers: Tá, Deputies Marie Sherlock and Duncan Smith; Níl, Deputies Mary Butler and Emer Currie.
Amendment declared lost.
Motion agreed to.
Is féidir teacht ar Cheisteanna Scríofa ar www.oireachtas.ie.
Written Answers are published on the Oireachtas website.
Cuireadh an Dáil ar athló ar 11.35 p.m. go dtí 8.47 a.m., Déardaoin, an 26 Feabhra 2026.
The Dáil adjourned at 11.35 p.m. until 8.47 a.m. on Thursday, 26 February 2026.