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IRELAND IS ONE of few EU countries where the patient load of GPs has increased over the past decade.
Each GP has an average of 100 extra people in their catchment area due to a surge in population that has not been matched by an equivalent rise in doctors here, The Journal Investigates can reveal.
Experts told us that this is exacerbating a primary care crisis, where GPs are firefighting to treat ageing and growing communities who are finding it more difficult to get access to care.
“Over a protracted period… the health of the population will be eroded,” Tadhg Crowley, an associate professor in general practice at UCD, told us.
Ireland’s population grew by over 630,000 in the 10 years between 2014 and 2023.
To maintain the same patient load, GP numbers should have grown by almost 600 in that period, but instead just 176 additional doctors were working in surgeries around the country.
GP numbers fluctuated in Ireland over the past decade, peaking at over 4,800 in 2018 before dropping again. This stood at just over 4,500 clinically-active doctors working as GPs in 2023, according to the latest Medical Council workforce report.
Europe overall is facing a shortage of doctors across all specialisations and the deficit of general practitioners is a particular problem.
Data compiled as part of this investigation by the European Data Journalism Network (EDJNet) reveals that the profession in many countries, including Ireland, is in a difficult situation: The population is growing and ageing, while GPs themselves are ageing and their numbers are struggling to keep pace.
The Journal Investigates is the Irish partner in this cross border investigation, led by Voxeurop. Alongside Ireland, we found that the patient load of GPs in Italy, Bulgaria and France has also grown in recent years.
In the other eight EU countries examined by the team there was a decrease in the number of people per GP.
It is hard to say what the optimum number of patients per doctor is, but Elodie Brunel, vice-president of the Société Scientifique de Médecine Générale in Belgium told our investigative team:
“We estimate 800/900 patients [per year] per doctor is the threshold beyond which it becomes difficult to function.”
Our investigation findings show that most European countries, including Ireland, are operating at a far higher level than this. From latest population estimates, Ireland would need almost 6,000 GPs to meet that threshold.
The shortage comes as Ireland is “in the middle of a health tsunami”, according to UCD’s Crowley, who runs a medical practice in Kilkenny City.
This is not only due to an ageing population but also an obesity crisis which “lends itself to increased chronic disease”. The proportion of GPs decreasing is “only going to add to this health burden”, he said.
Method: The data collected for this article is fragmentary. Each country counts its GP workforce differently, so creating comparable data is complicated. We chose to focus on GPs confirmed as being in practice. In Ireland, this equated to clinically-active doctors that self-reported working as GPs to the Medical Council each year.
In some countries, GPs are not the only doctors who provide primary care. This is particularly the case in Germany (for internists) and Greece (for pathologists). As a result, our graphs don’t show the full range of primary-care providers in these countries. The full investigation methodology is detailed by Voxeurop here.
Using the – very partial – data the investigation team has been able to gather at a European level, it’s possible to sketch a picture of the crisis in several countries.
The causes are numerous and complex, and the situation is becoming pervasive.
“There are shortages of GPs all over the world,” explained Tiago Villanueva, a GP in Portugal and president of the European Union of General Practitioners.
He sees this as a Europe-wide problem, both within and outside the EU.
“It’s not just a problem of pay… and working conditions,” he said, citing Norway and Denmark as examples. Despite a high quality of life and good wages, both of these countries are also facing shortages.
Villanueva mentioned other factors that may play a part. These include the difficulty of the job, long travel times and the fact that shortages are often in poorer and less desirable regions.
A report by the World Health Organisation (WHO) in 2023 also mentions “imbalances in the geographical distribution of primary healthcare professionals, mainly between rural and urban areas”.
In the EU, inequalities in healthcare provision between rural and urban areas are well known and well documented.
The term “déserts médicaux” (medical deserts), although disputed, has become widely used in France to refer to areas, often rural, with poor access to healthcare.
Ireland is no exception, with UCD’s Crowley telling us that the shortage here is not evenly spread:
Rural general practices are in trouble.
That is because many younger GPs want to work in bigger practices and some counties also have a higher percentage of GPs close to retirement, he explained.
Last year, the Irish College of GPs (ICGP) found that counties with large urban areas – Dublin, Cork, Galway, Limerick and Waterford – had among the highest GP numbers per population. Co Monaghan and Co Meath had the lowest.
Some EU countries are responding with incentives such as in Romania and Belgium where subsidies exist to encourage family doctors to set up practice in areas of shortage.
Ireland is not unique with its ageing population. Across Europe the population – estimated at 449.2 million in 2024 – is growing but it is renewing itself at a much slower rate.
A recent OECD report found: “The proportion of people aged 65 and over in the EU has risen from 16% in 2000 to 21% in 2023, and is expected to reach almost 30% by 2050.”
This, it stated, is due to longer life expectancy and lower fertility rates and is “likely to lead to a sharp increase in demand for healthcare and long-term care”.
The ageing of the population also holds true for doctors themselves, across all specialisations.
The report Health at a Glance: Europe 2024 states: “The ageing of the physician workforce is a growing concern in many EU countries, with a substantial proportion of doctors nearing retirement age and a non-negligible number already beyond it.”
Over one third (35%) of doctors across EU countries were over 55 in 2022.
This is no different in Ireland, with a substantial proportion of GPs (32%) close to retirement age, according to 2023 data from the Medical Council.
The World Health Organisation set out a number of solutions for combating shortages in its 2023 report.
This included prioritising general medicine in higher education through internships or training sessions, improving salaries and working conditions as well as gaining a better understanding of healthcare delivery.
Increasing the number of GPs being trained is often a solution proposed by governments, according to Villanueva of the European GPs’ union “because if you increase supply, you offset demand”.
But he told our investigation partners Voxeurop that this approach needs to be accompanied by measures that make the profession more attractive to aspiring young GPs and ensure that the workforce is retained in the long term.
“If you don’t make the profession more attractive, then you may inject more doctors into the system but they won’t go into general practice.” Instead, he said:
They’ll choose another speciality or they’ll leave the country.
Research published at the end of last year looked at just that – GPs who have left Ireland – and concluded:
“There is a significant stock of Irish-trained GPs abroad which perhaps represents a potential cohort of GPs who could be encouraged to return to practice in Ireland as part of Ireland’s strategy for addressing the GP workforce crisis.”
Crowley told us targeting those who have emigrated is crucial: “Why are we not looking after our graduates who move abroad?”
Citing the expenses of setting up a practice, including the legal implications, he suggested offering grants to “encourage these GPs to come back and set up in areas” of shortage.
In addition, Crowley said the number of doctors on the GP training programme from Irish-training universities needs to be examined, as he felt with graduates coming from outside Ireland, “there’s a higher likelihood that they will go back abroad again”.
In response to a recent parliamentary question on the GP shortage, Minister for Health Jennifer Carroll MacNeill said that “a number of measures have been taken in recent years to increase the number of GPs”.
This included the annual intake of doctors into the GP training programme increasing by 80% in the past five years, with 350 places made available from 2024.
The minister also mentioned an increase in the annual expenditure for general practice in recent years as well as the introduction of a grant support for additional staff capacity as well a practice staff maternity leave support. She said:
These measures make general practice in Ireland a more attractive career choice for doctors.
Recruitment of GPs from abroad also started in 2023 under a joint HSE and ICGP programme. 114 such GPs were in practice as of October, according to the minister, and funding has been provided to recruit up to 250 more GPs from outside Ireland to the country this year.
But expert Tadhg Crowley said the government needs to look at multi-annual funding and say: “Right, this problem is going to get worse and worse. We need not to be firefighting.
“We need to look at how are we going to increase the number of GPs trained from Irish universities, and then making sure that when the person has done some traveling, that they want to come back to our health system to work.”
Are you impacted by the GP crisis? We want to document how people across Ireland are struggling to access primary care. Find out more here>>
This investigation was led by Voxeurop alongside other members of the European Data Journalism Network (EDJNET), including The Journal Investigates.
Reporters / Editors: Maria Delaney (The Journal Investigates) & Adrian Burtin (Voxeurop) • Additional Reporting: Patricia Devlin • Main Image Design: Lorcan O’Reilly
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Have these people no work to go to?
@Josh Hanners: NO.
@Josh Hanners: I find this response childish and churlish. I for one worked all my life at different times and nearly always at weekends.
@Josh Hanners: they probably do but they choose not to.
@Bernard Kavanagh: So they’re all shiftworkers?
@Josh Hanners: you’re right. There are more important things in life than protesting during work hours. And I for one am not going to support anybody who doesn’t work or the causes that these layabouts support. Delhi is fake news : these wasters are the real pollution
@Josh Hanners: I will be there as a pensioner , for me it’s so Important to support this action. The future of this planet is a priority, especially for the future of our next generations. What you prioritise I haven’t a clue?
@Josh Hanners: Its called ‘Lunch time’ ! Taking your lunch break to do something about climate and biodiversity breakdown….
@Bernard Kavanagh: I’ll do my bit when private jets and cruise liners are banned.
Until then, I carry on as is.
@Josh Hanners: I hope it freezes and pis s rain while they do their beach stunt.
I will be at home in with a nice warm stove and a nice stack of firewood coal with turf.
@Josh Hanners: they could book time off and if that’s what they believe in so be it don’t be a hater son
They might need to rethink the wardrobe in that rain…..
the only way for Ireland to fight climate change is to increase taxes on middle income families. Bankrupting the squeezed middle is the only way we will guarantee a future for our children
@Dean Anderson: nonsense unsubstantiated comment but apparently popular with “put upon” Journo readers. Ther are lots of ways to combat climate change beyond taxation. Unfortunately FFG are bereft of ideas.
@Dean Anderson: the middle class buy products sold by the upper class and made by the working class.
Something tells me this will be like when I was a kid and went to Spain on holidays and saw there was a nudist beach. There weren’t too many beautiful young bodies to see.
He fell just short of saying “What’s the point of doing anything, because y’know China and India?”
@Paraic: fully agreed look at India at the moment you could barely see your hands in front of you with the smog all this because is a developing country and neighbouring countries burning land and stubble. In reality what difference is a little country in the Atlantic going to make
@In my opinion: Fake news. An Indian person only produces 1/4 the CO2 of an Irish person. India has being embracing sustainable energy, to the point that it’s likely to reach it’s Paris accord agreement 10 years ahead of its goal. “TOP OF THE CLASS: INDIA: India has emerged as a global leader in renewable energy, and in fact it is investing more in them than it is in fossil fuels. Having established a goal of generating 40 percent of its power through renewables by 2030, its progress has been so rapid that it could easily reach that target a decade early.”
https://tinyurl.com/yy6lqbum
@In my opinion: Are you really saying that Ireland and presumably the 110 other similar sized or smaller countries should be off the hook, because look over there China and India are doing nothing (a false statement)? Would the UK be big enough? What’s your size threshold before countries should bother?
@Stephen McCluskey: Smog and CO2 are two completely different things. A brief cooling around the 1940s is attributable to smog due to the industrial effort of WWII. It may not be desirable, but it’s also not the cause of global warming. Also, did you check to see how climate change increases the hang time of smog? “Wind usually helps blow away smog, but changes in weather patterns in recent decades have left many of China’s most populous cities poorly ventilated, scientists say.”
@In my opinion: What sort of an attitude is that? if we all think like that nothing will change and if we think any other way nothing will change so I suggest you listen to the climate change agitators and get on board with their message as life will be a lot easier for you in the long run even if nothing you or I do will have any impact on the changing climate.
@Paraic: Extract from a 2017 report from the IER: “With the United States on its way to official withdrawal, China and Germany are expected to take the lead promoting the Paris Agreement.[i] This is despite China’s role in constructing over 700 new coal-fired power plants around the world. According to Urgewald, an environmental group based in Berlin, some of these new coal plants will be built in countries that burn little or no coal today. While many of the coal plants will be located in China, about one-fifth of the capacity of these new coal power plants is going to be located in other countries.[ii]
China is not alone in constructing coal-fired power plants. According to Urgewald, about 1,600 coal plants are planned or under construction in 62 countries; this data comes from the Global Coal Plant Tracker portal. If constructed, these new plants would increase global coal-fired capacity by 43 percent. According to Urgewald, 11 of the world’s 20 biggest coal plant developers are Chinese.”
“The world’s largest coal-plant developer, however, is India’s National Thermal Power Corporation, which plans to build over 38 gigawatts of new coal capacity in India and Bangladesh. India’s state-run power utility plans to invest $10 billion in new coal-fired power stations over the next five years. Despite several relatively new coal-fired plants being idle, it plans to build three new plants with a combined capacity of over 5 gigawatts. The new plants consist of two 660 megawatt units: one is being built at Singrauli in central India’s Madhya Pradesh and the other at Talcher in Odisha in the east. Its biggest plant will have a capacity of 2.4 gigawatts and will be located in the eastern state of Jharkhand. The new coal-fired plants will be “supercritical” plants that are 2 to 3 percent more efficient than conventional plants and therefore have lower emissions.”
@Blessopaddy: “That American think tank is the Institute for Energy Research, which has received $307,000 from ExxonMobil since 1998 and unknown additional sums from other oil and coal industry sources. The Guardian reported last year that the Institute for Energy Research has received recent funding from KBR and trusts set up by Koch Industries, which has multiple ties to IER and its sister organization American Energy Alliance. Danish journalists have confirmed that The Institute for Energy Research commissioned and paid for the anti-wind energy study released last year by a Danish think tank that claimed Denmark exaggerates the amount of wind energy it produces (it doesn’t), and asserted that the U.S. should choose coal over wind because it’s cheaper.
…sooooo a history of fossil fuel vested interest finding and straight up lying. Do you even believe it yourself or just trolling?
@Paraic: All reports are biased, whether they’re produced by left wing or right wing think-tanks. I guess that’s why ordinary punters such as ourselves find the unadulterated truth is often hard to come by. But any number of reports have stated that China and India – though reducing their dependency – are still heavily involved, and continue to invest, in coal produced power – and as do many other countries. As for Denmark, I’ll leave the last word with the Wind Denmark web site: https://en.winddenmark.dk/wind-in-denmark/current-energy-production – well done the Danes!
@Blessopaddy: So the publishings of a madey up Institute for Energy Research founded by Charles Koch of Koch Industries and CEO Robert Bradley, a former Enron executive, with the sole interest of promoting the use of fossil fuels and to discredit renewable energy with lies, is the same as peer reviewed science research or genuinely independent journalism? Give over. This is no “think tank”, it’s a blatantly obvious sockpuppet fake news outlet directly funded by and chaired by fossil fuel magnates.
@Paraic: of course and all the “research” you want to believe is real because it is peer reviewed by who? Peers who all believe the sane thing. Fact is all these “models” use made up constants and assumptions to fit the scientists agendas or more precisely the agendas of those that are paying their grants. I’m not saying climate change isn’t happening, just wake up anf stop believing everything you are told, its called being gullible.
@Blessopaddy: OK I missed part of your post. Denmark is doing great with wind energy. I don’t agree that it’s difficult to separate truthful articles from fake news. You have to look at who is behind the source of the data.
I already knew that China are embracing renewable energy and switching from coal from New Scientist magazine, which I happen to know it’s a highly reliable and trustworthy source that I’ve been reading since my college days. When I read your post, I instantly knew that it was full of lies and disinformation. I hadn’t heard of “Institute of Energy Research”, but it was obvious that it was the voice of vested interests. A quick Google search confirmed it. People need to stop taking stuff at face value. We now live in an age of sponsored disinformation.
@Dino: You don’t need to refer to models if you don’t like them because you don’t understand how they or science works. California is already burning. This graph is not from a model, it’s real world data. Time to wake up! Being able to read and interpret it, is not being gullible. https://tinyurl.com/yxwc6bbd
Time to wake up!
@Paraic: thanks; I didn’t know that
@Paraic: so California and the likes has never gone through this in the history of the world before cars and man made pollution?
@Dino: No, not in at least the last 10,000 years.
There is no climate man made change…
… said no climatologist ever.
@Gerard Casserly: says the idiots who cannot read or understand science.
They all have lovely bottoms.
well need the ‘warmer winters’ to avoid our elderly relatives ,the disabled ,homeless and the poor from freezing to death through fuel poverty -thanks to the increases in carbon tax and pso levies introduced by his government !! he really does not give a shi*
The whole thing is cringe. Go back to work, bloody bunch of good for nothing hippies
Not too many serious comments so far, so let me put the thing in contextt. For many reasons, Nasa’s model predicts that global warming due to human activity should begin to taper off towards the end of this century. By then however, the beaches along with many coastal cities will probably be under water at low tide and there’ll be a lot more rain. Increased temperatures and humidity along with that exposed and ice-free tundra will encourage insects to take over from us and not the nice guys like bees. Happy New Monday.
@Denis McClean: ok Denis.
My argument is we are a field in the middle of the Atlantic. We account for less than .1% of carbon emissions. We are been hit with carbon taxes and what not.
Are the folk in India China or the US been hit with all these charges or are they making changes to their lives to help climate. It’s all in vein until they step up. My money will stay in my pocket
@Stephen: China and India are not only doing something, they’re both world leaders in embracing renewable energy and are 8 to 9 years ahead of the Paris agreement. The US is doing virtually nothing and is simultaneously the worst polluter on the globe. Their excuse, “Why should we do anything until India and China do something first?” With respect to Ireland being small, so are 110 other countries. Are we not part of the EU? Why is the EU exempt from carrying any of the burden? Most EU countries produce 4 times the CO2 per capita as India.
@Stephen: Point taken but carbon taxes may be an infantile solution but they are also a seperate issue.
Pull mercosur off the table immediately.
@Declan O Toole: And eat less beef….
These wasters shouldn’t be covered in the news.. Serious gap in the market for a non polarized news source
Yayyyy
Who ties his shoelaces?
That sounds like a lot of arrests for indecent exposure!!
When are the farmers having their bi annual fodder crisis m
When they hide their 19 2 crew cabs and go begging and pretending to be broke
That will take the smile off Leo’s face
Can’t anyone take a joke anymore????
@Colm Walsh: Are you joking !
All putting their little heads together brainstorming: Now what can we do to get ourselves in the media next week? actually caring about the future of the earth does not take precedence over themselves. attention seeking gobs**es
@Pauline Gallagher: You seem to really care Pauline, good on you, why don’t you go outside and hug the earth or a tree or something. It will probably have as big an impact on global climate change as anything else you or anyone else in this country will have. A lot of people (who are educated and should really know better) will say that we have a responsibility and that loads of other small countries doing something will have an impact. It won’t, FACT! just look at the numbers. The only chance people have of positively impacting climate change is if the big countries put their shoulders to the wheel. In the meantime all the rest of us mugs are doing is just putting ourselves into penury to masage the ego’s of the climate change nazi’s.
@Dino: Climate change doesn’t respect borders. 5 million people anywhere on Earth is 5 million people. What will you tell your grandchildren when they ask you what contribution you made to prevent the world from burning? Will you look them in the eyes and say “I am from a small country of 5 million and I thought to myself, what good could 5 million people possibly do? So I did nothing.”
@Paraic: like it or lump it dino is correct
@Paraic: I’ll tell them a bunch of idiots like paraic did their damndest but didn’t make a blind bit of difference as their was 1.4bn people in another country who decided to go a different route. If you were in a barrell and 280 people started pissing into it do you think you could throw enough piss out with an egg cup to save yourself (accepting they have unlimited bladders)?
@Dino: Classy analogy. Except everyone is in the barrel and everyone has an eggcup and most people think it’s a good idea to use it to bail, except you. You must like drowning in your own piss.
@Paraic: err as per most of your posts you just don’t understand the analogy. The 280 people are just the Chinese as they have roughly 280 for every person we have in Ireland, so no not everyone is in the barrell. The whole point was if everyone was in the barrell bailing it out there would be less people filling it and more people emptying it leading to the possibility of us making a difference. You my lost man ha e zero chance of making an impact on climate change the same as everone in Ireland and even in Europe I would say. The only way there is any chance (if you believe climate change is man made) is if china, us, india, and all the other big polluters decide to do something about it. I know its sad to think you can’t make a difference with your little crusade but it is wasted effort I’m afraid.
@Dino: I understood the analogy. I was pointing out that it’s flawed. Because in reality everyone is in the barrel and there are another 120 guys like Ireland in there too representing other small countries. Should they do anything? Why do you bother getting out of bed with that mentality.
@Paraic: I bother getting out of bed as life goes on regardless, I don’t need to be an attention seeking agitator to make my life feel worthwhile. Your response clearly shows you don’t get the analogy as all these 120 small countries like Ireland are still vastly outnumbered by the super countries and while it might hurt your little head to accept it there really isn’t any alternative
I’m so glad these wastes of space and oxygen I.e. the Extinction Rebellion mish mash have the time to take days off to protest over BS!! Varadkar, who I don’t have any time for, in this case, his comments were reasonable, accurate and balanced. I can only come to one of two conclusions, this mish mash must either have very reasonable bosses or two, the haven’t worked a day in their lives. I’m inclined to go with the latter!!
Jaysus lads, I don’t like Leo much at all but he was just making a valid enough point. He’s not saying he supports it, he’s just stating that it is an aspect of climate change
Vote Cowan – Dickie
So you think that as a head of a country, climate change is only a problem…when it reaches your country?! And still don’t see the reality in California which is in flames ‘Because they don’t don’t sweep their own forests?!’ Leo?! That sounds like two really smart men to me. Talking to their own people while being head of the countries.
I hope the weather holds fine for them tis a bit chilly to be out in a bikini there’ll be nipples like bullets
Colcannon must be holidays
God …what a stupid thing to say. The spin doctors need to reign Mr varadkar in.
Sounds like a might in the George ..
Colcannon must be on holidays
There won’t be a an Ireland in 20 Years time anyways Taoiseach So do t worry your little cotton socks.
have your say