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.