Skip to main content
SpringerLink
Log in

How does the introduction of free GP care for children impact on GP service provision? A qualitative study of GPs

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Optimising child health in general practice is a key health service priority. In Ireland, where 23% of Ireland’s population are aged under 16, GP consultations have historically involved a private fee or have been covered by Ireland’s General Medical Services (GMS) scheme. In July 2015, this scheme was expanded so that free GP care was provided to all children aged under 6 years. Recent research suggests this change in policy has led to a substantial increase in the number of children under six attending both daytime and out-of-hour GP services and highlights a need to better understand the perspectives of GPs on this policy change.

Aim

To address these knowledge gaps, this paper aims to examine GPs’ views on the scheme and how it has impacted on their practice.

Methods

Sixteen GPs participated in semi-structured telephone interviews between June and August 2016, analysed using inductive thematic analysis.

Results

Six key themes were identified: (1) increased service utilisation, (2) changes in parental behaviour when accessing services, (3) increased ‘out of hours’ service utilisation, (4) dissatisfaction with the current resourcing of the scheme, (5) limited capacity to support expansion of free GP care, and (6) reduced antibiotic prescribing.

Conclusions

The study highlights how introducing free GP care to a mixed private/publicly funded health system may impact on GP workload, parents’ interaction with services and physician practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ED :

Emergency Department

GP :

general practitioner

GMS :

General Medical Services

GPVC :

General Practitioner Visit Card

HSE :

Health Services Executive

ICGP :

Irish College of General Practitioners

OOH :

out of hours

References

  1. Behan W, Molony D, Beame C, Cullen W (2014) Does eliminating fees at point of access affect Irish general practice attendance rates in the under 6 years old population? A cross sectional study at six general practices. Ir Med J 107:121–122

  2. O'Mahony DFU, Hannon F, Kloeckner K, Avalos G, Murphy A, Kelleher C (2007) The lifeways cross-generation study: design, recruitment and data management considerations. Ir Med J 100(8):3–6

    Google Scholar 

  3. O’Callaghan ME, Zgaga L, O’Ciardha D, O’Dowd T (2018) Free children’s visits and general practice attendance. Ann Fam Med 16(3):246–249

    Article  Google Scholar 

  4. Watson J et al (2016) Proliferation of private online healthcare companies. British Medical Journal Publishing Group

  5. McCombe G, Henihan AM, Klimas J, Swan D, Leahy D, Anderson R, Bury G, Dunne C, Keenan E, Meagher D, O’Gorman C, O’Toole T, Saunders J, Smyth BP, Lambert JS, Kaner E, Cullen W (2016) Enhancing alcohol screening and brief intervention among people receiving opioid agonist treatment: qualitative study in primary care. Drugs Alcohol Today 16(4):247–258

    Article  Google Scholar 

  6. Teddlie C, Yu F (2007) Mixed methods sampling a typology with examples. J Mixed Methods Res 1(1):77–100

    Article  Google Scholar 

  7. Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K (2015) Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health Ment Health Serv Res 42(5):533–544

    Article  Google Scholar 

  8. Gelberg L, Andersen RM, Leake BD (2000) The behavioral model for vulnerable populations: application to medical care use and outcomes for homeless people. Health Serv Res 34(6):1273

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M (2011) Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health Ment Health Serv Res 38(2):65–76

    Article  Google Scholar 

  10. Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101

    Article  Google Scholar 

  11. Cullen P (2014) Under-6s scheme will mean extra 77 visits per GP. Irish Times, Dublin

    Google Scholar 

  12. Gorecki, P., The impact of free GP care on the utilisation of GP services in Ireland: an evaluation of different approaches. 2016

    Google Scholar 

  13. McGovern E, Morris R (2015) Medical workforce planning: future demand for general practitioners 2015–2025. Health Service Executive, Dublin

    Google Scholar 

Download references

Acknowledgements

We thank the GPs who participated in the study. We are grateful to the late Mr. Carl Beame of Complete GP who provided considerable insight and expertise to the study design. We are grateful to the UCD School of Medicine who supported this project through its support for the UCD Primary Care Research Group and the Summer Student Research Awards Programme (2016).

Author information

Authors and Affiliations

  1. School of Medicine, University College Dublin, Belfield, Dublin, Ireland

    Geoff McCombe, Neasa Conneally, Aine Harrold, Ayesha Farooq Butt, William Behan, David Molony & Walter Cullen

  2. Walkinstown Primary Care Centre, Walkinstown, Dublin 12, Ireland

    William Behan

  3. Mallow Primary Healthcare Centre, Gouldshill, Mallow, Co. Cork, Ireland

    David Molony

Authors
  1. Geoff McCombe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Neasa Conneally
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aine Harrold
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ayesha Farooq Butt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. William Behan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David Molony
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Walter Cullen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Walter Cullen.

Ethics declarations

Ethical approval was granted by the Irish College of General Practitioners’ Research Ethics Committee. All participants signed a ‘participant consent form’. All data was anonymised and informed consent was obtained from all who participated in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McCombe, G., Conneally, N., Harrold, A. et al. How does the introduction of free GP care for children impact on GP service provision? A qualitative study of GPs. Ir J Med Sci 188, 1245–1249 (2019). https://doi.org/10.1007/s11845-019-01997-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-019-01997-7

Keywords

Search

Navigation