Assessing how the policy of free GP care for children aged under 6 has impacted unscheduled paediatric healthcare in Ireland

The term “unscheduled” healthcare refers to care that is generally provided with less than 24- hour notice, with general practitioners (GPs) the most common first point of contact for this type of unplanned care (O'Cathain et al., 2007). The most significant change to paediatric unscheduled healthcare in Ireland in recent years has been the extension of free GP care to all children aged under 6 from July 2015. This policy provided access to daytime and out-of-hours (OOH) GP care at no charge to the 70% of children aged under 6 who were not existing holders of a medical or GP visit cardi, with GPs receiving an annual capitation fee per registered patient. While the removal of the barrier of cost might reasonably be expected to increase utilisation in the short-term, the longer-term impact on utilisation and possible health benefits needs to be better understood in order to inform future policy development. Using data from eight practices and an OOH service in North Dublin, O’Callaghan et al. (2018) found attendance at daytime GP increased by 29% and by 26% at the OOH service in the year following the introduction of this policy, while Nolan and Layte (2017) using longitudinal data from Growing Up in Ireland, estimated an increase in attendance of 25%. Using data from 16 GP practices located across 12 of the 26 counties of the Republic of Ireland and a large OOH GP service operating in the South-East of Ireland, the CUPID Project assessed that this policy led to an increase in attendance at daytime GP of 20% - 21% in the three years following its introduction (McDonnell et al., 2022). A larger effect was identified at the OOH service (21% - 29%). Across each of these studies, the increase in attendance was significant and, as shown by McDonnell et al. (2022), persistent.