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

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.

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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

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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).

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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.

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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

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

Keywords

  • Child health
  • GP service utilisation
  • Healthcare policy
  • Paediatrics
  • Primary health care