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Investigatesyour storiesTHE GP CRISIS has worsened over the past decade as a surge in population was not matched by an equivalent increase in doctors.
That was one of the main findings of a cross-border investigation published by The Journal Investigates last week.
Readers contacted us from cities and villages across Ireland following our report to tell us about how the GP shortage is impacting their health.
They were left praying their infections would clear up or resorting to already overcrowded emergency departments for care.
We also heard from doctors on the frontline of the crisis, struggling to retire with no GP to take over their practice.
Thank you to everyone who got in touch.
Here’s what you told us.
Daniel in Dublin said for about the last four to five years “you cannot make GP appointments”.
“The process for all local GPs is you need to ring at 9am to get an appointment for the day. And you take what you’re given. As you can imagine the lines are jammed whenever you try ring.”
This rules out arranging appointments in advance outside school times or for non-emergency, more routine check-ups, crucial for preventative care.
Daniel said that moving is not an option.
All GPs in the area are refusing new patients so you’re stuck with who you have.
This came to a head recently during a “bad run in our family with illness”. When Daniel’s wife “became extremely ill quickly in the afternoon” and was unable to get a GP appointment. Instead, she spent over 15 hours waiting to be seen in Beaumont Hospital.
“You tend to just power through your illnesses. Hardly ideal. Or for things I want to maybe get checked I tend to just put off since it’s a morning rush to try get a slot.”
Daniel told us he feels “the GP system has collapsed in recent years with no real urgency or notice about it”.
Another reader in Dublin said he was often “forced to bring young children to A&E in Tallaght or Crumlin” due to difficulties in getting GP appointments.
He said that they would be “lucky” to get an in-person appointment the same week, and can’t even get phone appointments the same day anymore.
The father worries about exposing his children “to further infections” in emergency departments. He spent nine hours waiting with his six-year-old the last time they needed to go.
Because a lack of GP appointments is driving people to hospitals, one reader said it was unfair that those who present to emergency departments without a GP letter are charged €100.
“Any person who has made a genuine effort to attend GP should not be charged.”
The Journal Investigates put this to the HSE who said that in addition to those who have a letter of referral “from a registered medical practitioner”, this €100 charge is exempt for people with medical cards or whose attendance results in admission as an in-patient.
Is this charge under review given the GP shortage? “There are no plans at present to amend these provisions,” the spokesperson told us.
The HSE said that “many injuries can be treated at the 14 injury units around the country”. These cost €75 to attend, though are free with medical cards or referral letters, including from an emergency department, but some have age limits.
They “treat recent injuries that are not life-threatening and unlikely to result in admission to hospital”.
When unable to access GPs, other readers turned to private online doctors or clinics which they said were costly, especially if not covered by health insurance.
Some hoped for the best and took GP appointments that were weeks away, leaving them anxious.
Because of “non-existent” appointments with her local GP, Bibi in Wexford said “the only option left” is an online doctor.
“A great service but at the same time you pray whatever infection you have will clear up with the small amount of information you give them.”
After working for over 45 years, she said “it’s just not acceptable to have to rely on this method”.
Marion in Kildare used to get an appointment within 24 hours “a couple of years ago” but now waits “a week or more”.
She said she doesn’t even bother looking for an appointment anymore as she has “to know a week in advance” if she’s going to be sick.
Instead, she asks her pharmacist for help. “But as I have heart disease and angina, he doesn’t be too eager to diagnose my condition or change any medications.”
Even when Brian in Donegal rings “at 9 o’clock on the dot”, he is often told “there are no spots that particular day”. Due to waiting lists, he said it’s also not possible to book in advance.
“It makes me more likely to push concerns off as I don’t think I’ll get seen when I want to be.
“I also feel guilty if I go and the doctor says that it’s nothing to worry about as I’ve ‘taken’ an appointment from someone else.”
Some readers who contacted us were waiting to be seen for a number of weeks for an appointment.
This included Sean in Louth who was “experiencing pain and discomfort” from a cyst on his wrist. He was told by his GP last year it would go away by itself but these new symptoms began recently.
When he rang his GP “looking to get it removed”, he was told the next appointment was two weeks away, and that he would need a referral to get it removed somewhere else.
“God knows how long I will be waiting to remove this cyst from my wrist.
This is a joke and the fact I will have to pay €60 for my GP to send a referral somewhere else is a disgrace!
A reader in Leinster who contacted us was waiting for two months to be seen to have an unexplained bruise on her breast examined.
When she initially called for an appointment, the secretary told her someone would call her back, but this did not happen. She called again two weeks later only to be told she would have to wait for six more weeks to see her doctor.
“This is not a minor inconvenience; it is a complete failure,” she said.
It leaves patients in limbo, forced to either wait indefinitely or seek costly private care.
“We are told to be proactive about our health, yet when we try, we are met with closed doors. How is this acceptable?”
When asked about lack of access to GPs and its impact on preventative care, a Department of Health (DOH) spokesperson said:
“The Government is committed, as per the Programme for Government, to increase the number of GPs practicing across the country and thereby improve access to GP care for all patients.
“A Strategic Review of General Practice is currently underway which is examining the broad range of issues affecting general practice.”
The DOH said that under the 2019 GP Agreement “additional annual expenditure provided for general practice was increased by €211.6 million” and €30 million was provided under the 2023 GP Agreement “to support additional capacity”.
They also detailed how the recent GP Agreement in 2023 “increased the available subsidies for practice staff and introduced new subsidies for additional staff capacity and for the taking of maternity leave”.
GP practices across the country are often closed to new patients, according to our readers, who told us they either opted to travel to see their doctor or had to turn to the HSE for help.
Brian in Tipperary has multiple sclerosis (MS) and said he is “lucky enough” to have a GP in Nenagh but it is a forty-minute journey for an appointment.
“So I’m trying to jam everything into one consultancy and it isn’t fair on them.”
He said that politicians “talk about universal GP care – that’s laughable”.
Another “lucky” reader said her GP does see her if she’s “desperate and they have time” but her doctor of 30 years is a two-hour drive away.
“She’s not even close to my work. It’s literally a day trip. Fasting bloods are a dizzy mess.”
Moving to a new area was a particular struggle highlighted by readers as they failed to find GPs to take them or their children on.
A reader who moved to Meath tried six local clinics but “everybody said they had no space”.
She was “devastated” but was told by her previous doctor in Dublin to call the HSE who, if you are turned away from three surgeries and have a medical or GP visit card, can assign a local doctor to you.
“So I did and I never experienced anything like that before,” this reader said, describing a process that involved being redirected by multiple HSE personnel before eventually finding someone who could help.
I think the whole system is absolutely flawed and broken.
When, eventually, her baby was assigned a GP, she was unable to get an appointment for a number of weeks and resorted to a private doctor in Dublin.
She did see her GP when her baby was sick but had to wait over two hours in the surgery to be seen.
“We are trying to avoid GP visits now. It is looking like it is more time efficient and more reliable to go and visit a private specialist even if it’s costly.”
When Lynne in Dublin was pregnant she “searched and searched for a GP”, but all the practices were full.
She didn’t find one until she was in her third trimester and had to pay for appointments, even for vaccines that are “supposed to be free” when pregnant.
Under the Maternity and Infant Care Scheme in Ireland, expectant mothers who are resident in Ireland are entitled to maternity care, even if they do not have a medical card.
After her baby was born, the practice continued to charge for care for the both of them as they did not accept the Under 8s GP visit card.
“Every GP Practice in my vicinity told me they were not accepting new patients, even for once-off vaccine appointments my baby needed. My baby was a few months old before the HSE was able to assign us a GP.”
When we asked the HSE about access to GPs, a spokesperson told us that “the HSE endeavours to accommodate patients seeking to register with their General Medical Scheme (GMS) doctor of choice”.
Currently, there are “over 2,500 GPs who hold a full GMS contract, with 700 additional GPs holding at least one public contract” such as childhood immunisation or for children under eight.
GPs prioritising appointments for private patients above those with GP visit cards was raised by two readers.
John in Wexford said “after being treated totally differently in terms of getting appointments”, he handed back his Over 70s GP visit card.
His GP told him that “he only has a certain number of appointments to give to GP card holders each month” and if this is exceeded “he will be warned by the HSE”.
When John was told he would either have to wait weeks, go to Caredoc or his local hospital emergency department, he opted instead to become a private patient at the practice.
Now he pays, with a recent visit involving a doctor consultation and bloods costing him €70.
After having stents in recent years, a 24-blood pressure monitor was recommended at that appointment, but since it cost another €60 and he had an upcoming cardiac MRI in the Beacon, “he didn’t see the point”. He added:
Thankfully, I have health insurance.
Another reader told us about how his daughter, who has MS and a GP visit card, was treated very differently to him, “a private patient paying €60 per visit”, when booking a recent appointment.
Martin in Meath rang his GP at 11.30am one Monday and was offered an appointment that afternoon or the following morning.
It turned out his daughter had rung the same GP two hours earlier only to be told the first available appointment was a full week away.
“There is something wrong with primary medical care in this country,” he told The Journal Investigates.
This lack of service results in stress for Martin’s daughter, which he said “is a well recognised trigger for aggravating MS”.
He also said that services which were once free of charge for his daughter, such as routine bloods, are now costing her money.
Routine blood tests may be covered by medical or GP visit cards, according to Citizens Information. It advises people to make a complaint to your local HSE Health Office if incorrectly charged.
On GP visit cards, the HSE said: “Within the GMS contract, the medical practitioner accepts clinical responsibility for medical treatment of persons on their list.”
As part of this, GPs “shall ensure no discrimination or differentiation occurs between the treatment of eligible and private patients within the practice, and take reasonable steps to ensure that no such discrimination is perceived”.
The spokesperson recommended that people contact HSE Live for support.
Along with an ageing population in Ireland, a substantial proportion of GPs (32%) are close to retirement age, according to 2023 data from the Medical Council.
This is also true beyond our borders, with over one third (35%) of doctors across EU countries over 55 in 2022.
A recent OECD report said this was “a growing concern in many EU countries” and that concern was reflected in many emails that arrived in our inbox last week.
Readers told us about their GPs wanting to retire but feeling they had to stay working as there would be no doctor in the area. Others said when their GP retired they were left in limbo, with no care for months.
The gap in GP care is exacerbated in rural areas. Our investigation highlighted inequalities in healthcare provision between rural and urban areas in Europe.
A GP in a rural part of Leinster told us that she is less than 10 years away from retirement and is ready to help other GPs take over but added: “This is fantasy.”
She has trained a number of students and registrars over the past few years but every single one said that it’s a “great experience but, no, they don’t want to live in a rural area”.
The nearest town to the GP practice is a 15-minute drive but Dublin is over 1.5 hours away.
My hope is that young GPs will realise that there’s life outside the Pale.
The rural GP saw many young doctors leave for Canada, Australia and the United States over the years.
Emigration is an issue highlighted to us by another doctor who contacted us after our investigation was published. He told us this not only affected GPs, but also specialists who work in hospitals.
“Doctors going abroad is a massive problem, however, this is largely portrayed as being due to pay which is so, so wrong.
“No one I know went to Australia for money; they went for the opportunity to get on training schemes and for better conditions. That’s literally it.”
The Journal Investigates found that each GP has an average of 100 extra people in their catchment area over the past decade due to a surge in population that has not been matched by an equivalent rise in doctors here.
Incentives for rural practices and attracting doctors who emigrated back home were key recommendations made by experts who spoke to our team.
The Department of Health told The Journal Investigates that the strategic review examining issues affecting general practice is giving specific consideration “to possible further mechanisms to attract more GPs to rural and underserved areas”.
When completed, the spokesperson said, “the review will set out the measures necessary to deliver a more sustainable general practice into the future”.
They also said that “specific supports are in place to support eligible practices in rural areas” and this was increased by 10% under the 2019 GP Agreement.
GP training graduates have also increased, the spokesperson said. “The annual intake to the GP training scheme was increased by approximately 80% from 2019 to 2024, with 350 new entrant training places made available from 2024.”
The DOH cited a survey from the Irish College of GPs (ICGP) and said it “indicates that those considering emigration is low” from a sample of current GP trainees and recent graduates.
The HSE said it is “actively working” in collaboration with the DOH, Irish Medical Organisation (IMO) and ICGP “on a range of measures to increase the GP Workforce” and in developing a sustainable model of general practice.
An initiative “aimed at expanding GP workforce in rural and urban disadvantaged areas” was cited by the HSE spokesperson. There are over 100 overseas doctors working for a two-year period in Irish GP practices as part of the International Medical Graduates (IMG) Programme.
This has “helped ease the pressures on GP Practices in the southwest, southeast, midlands and western seaboard”, they said.
A number of readers told us about their positive experiences.
One father, Micheal, said his son was home from Dublin recently and had a bad cough and cold sweats at night. When he contacted his local GP, he got an appointment to be seen an hour later.
He was “back home at 11.15am” with a diagnosis and medicines from the pharmacy.
Another reader, Stephen, moved to Sligo from Dublin with his wife late last year. When they contacted their local GP, they were accepted as patients and given “introductory appointments within a week”.
“We both found the care to be excellent and are very grateful to the clinic and its staff for sparing us from that potential stressful part of moving home.”
Maria Delaney is the editor of The Journal Investigates. Our investigation into the GP shortage was led by Voxeurop alongside other members of the European Data Journalism Network (EDJNET), including The Journal’s investigative unit.
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