Minister for Health welcomes publication of ESRI’s Health Service Capacity Review report on future capacity requirements for GP services
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From: Department of Health
- Published on: 18 June 2025
- Last updated on: 18 June 2025
Minister for Health Jennifer Carroll MacNeill TD has today welcomed publication of the second Health Service Capacity Report produced by the Economic and Social Research Institute (ESRI) on behalf of the Department of Health. The report projects future demand for general practice services in Ireland to 2040. It confirms that our growing and ageing population, along with the shift to provide greater care in community-based settings, will drive a substantial increase in demand for GP services. This will require a corresponding increase in the number of GPs and GP Nurses.
The report sets out the level of increased demand and identifies a need for between 943 and 1,211 additional GPs and between 761 and 868 additional GP Nurses by 2040, based on the existing consultation ratios. A lower number of GP consultations – due to increasing complexity or shorter working hours – would require a greater number of GPs.
In 2023, there were 5.3 million people in Ireland. This is expected to grow by 15% to 6.1 million by 2040. Approximately 87,000 people were aged 85 years and over, projected to more than double by 2040 to 204,000 people. Older age groups tend to use healthcare services more frequently and for longer durations.
Minister Carroll MacNeill said:
"The report will make an important contribution to our work in increasing the supply of GPs, GP Nurses and other staff essential to general practice over the next fifteen years. The report highlights the challenge we face in ensuring that our population continues to have access to quality GP services.
“We are already expanding GP training places by 80% since 2019, now offering 350 places annually. Through the International Medical Graduate programme, developed in cooperation with the ICGP, we are recruiting GPs internationally, particularly for rural areas.
“Government spending on general practice has risen from €560 million in 2019 to €955 million in 2024, a 70% increase. This funding supports the 2019 and 2023 GP Agreements, including the Chronic Disease Management Programme, increased support for practice staff, and expanded free GP care for children aged 6 and 7 and those earning up to the median household income.
“The ongoing Strategic Review of General Practice, due to complete its work this year, will outline new ways to ensure we have the capacity to provide essential GP services.
“More also needs to be done to increase capacity across primary care and other services in the community to provide additional choice and access to services for people. This is why we are also focused on expanding the role of pharmacy through implementing recommendations made by the Expert Taskforce to Support the Expansion of the Role of Pharmacy in Ireland. Since last year, pharmacists can extend prescription validity from six to twelve months under certain conditions. We're also working to establish a Common Conditions Service in community pharmacies. These steps will enhance community healthcare capacity.”
The Department of Health is committed to building a demand and capacity modelling capability, necessary for any modern health system, as part of the ongoing collaboration between ESRI and the Department of Health. The report being published today is the second of a series of Capacity Review reports on Ireland’s health service. The first report, on public acute hospitals, was published on 28 May 2025, and the third report, on older persons care, will be published shortly. The ESRI will also publish further regional analysis later this year.
2018 Capacity Review:
The last Capacity Review was undertaken in 2018 to project future capacity requirements for the Irish health service. That review concluded that in all scenarios, there would be increased demand and also that significant reform was required.
The 2018 Review is now considered to be outdated and no longer fit for purpose. It did not include regionalisation, investment and demand shocks from Covid-19, or macroeconomic, demographic and cost shocks. We also have a changed – and changing – health and demographic landscape; with a growing, ageing and more diverse population combined with policy responses that have been developed as part of Sláintecare which need to be considered in our long-term planning (e.g. urgent and emergency care, waiting lists programme, elective care, etc.)
2025 Capacity Review:
The Department of Health and the Health Service Executive (HSE) engaged ESRI as part of the Department of Health-ESRI ‘Joint Research Programme in Healthcare Reform’ to undertake a new Capacity Review to inform long-term strategic planning. The ESRI has built out their Hippocrates projection model that provides base year estimates and projections of demand, capacity and expenditure.
The Hippocrates projection modelling estimates activity rates in a 2023 baseline by age and sex. Demand is then projected by multiplying activity rates by projected population in 2040. Various assumptions and scenarios are applied to give a range of projections for services and bed capacity. The health services experienced significant disruptions to the usual trends in activity across COVID-19, and while services are recovering, the environment for future planning was more uncertain for the 2025 Capacity Review than for the 2018 Review.
The 2025 Capacity Review is projecting future demand (to 2040, at a National and Health Region level) for:
(1) Public Acute Hospitals
(2) General Practice services
(3) Older Persons services
The ESRI is publishing national capacity projections over the course of May and June, with regional projections to follow later in the year. ESRI will also update the Hippocrates Query Interface (a version of the model with more limited functionality available to officials) for inclusion of latest available data.
The Capacity Review has identified the need for more detailed consideration of the capacity requirements for a number of areas of healthcare delivery. In 2025 and 2026, the Joint Research Programme will examine Occupancy Rates, capacity requirements for Short-stay, Rehab and Day Centre Care services and capacity requirements for Critical Care. These research projects will inform future capacity planning. Other areas of focus will be identified on an annual basis in line with strategic requirements of the health system.
In relation to activity rates, it is important to recognise that there was considerable disruption to healthcare delivery during the COVID pandemic. Parts of the health service have been reporting high post-COVID growth rates in activity, which have put pressure on the system and trends in activity have been less predictable than in the pre-COVID period. The 2023 base year was chosen as it reflected the most up to date post-COVID data available. Examination of the underlying data was undertaken to ensure the 2023 base year was robust. Patterns of healthcare utilisation in the 2023 base year are now broadly comparable to the pre-COVID period, providing confidence in the accuracy of the projections.
The Capacity Review will not be a one-off standalone piece of work, but rather the Hippocrates projection model will be developed over time to allow for the inclusion of future additional data (e.g. census 2026) and policy considerations as required, to produce regular capacity projections in the future. The projections can provide us with a baseline against which we can test the impact of different interventions.