The data in this publication is provided to the Central Statistics Office by the Primary Care Reimbursement Service (PCRS). The Primary Care Reimbursement Service (PCRS) is responsible for reimbursing GPs, Dentists, Pharmacists, Optometrists/Ophthalmologists, and other contractors who provide free or reduced-cost services to the public across a range of primary care schemes.
PCRS supports the delivery of primary healthcare by providing reimbursement services to primary care contractors for the provision of health services to members of the public in their own community. Almost all payments for publicly funded healthcare services provided in the community by GPs, community pharmacies, dentists and optometrists/ophthalmologists are made by the PCRS.
Under the General Medical Services(GMS) Scheme, provides access to medical and surgical services for persons for whom acquiring such services would present undue hardship. They may be granted a medical card or GP visit card and receive free general medical services for themselves and their dependants. All GMS claims are processed and paid by the PCRS.
The data in this publication includes persons who are eligible for the GMS only. Claims made under other schemes managed by the PCRS are not included in this publication.
Further information About PCRS and PCRS Publications can be found on the HSE website.
There are some differences between figures presented in this publication, and publications composed by the HSE PCRS. These figures are not comparable. CSO figures are calculated from a claim records data set, while HSE PCRS figures are calculated from a claim record and expenditure data set. This data set that this publication is based on includes only treatments and costs for treatments for where claims were filled out in full, processed and paid.
Incomplete claims are not reported in this publication. Claims were deemed incomplete if they lacked patient information (e.g. gender, date of birth, region). The use of only fully complete claims enables the breakdown of the figures by age group, gender and Local Health Office Region which is a valuable dimension of the data set.
The figures derived in this publication refer to treatments that were carried out in the corresponding year. Treatments carried out in one calendar year, but not claimed until the following calendar year do not always appear in this claims data set. Furthermore, claims which are rejected and not processed until the following calendar year do not always appear in this claims data set.
Pharmacy claims under the GMS and DTSS schemes include claims for GMS reimbursable prescription items only. The CSO expenditure figures include ingredient cost of medicines, dispensing fees and VAT where applicable for these GMS reimbursable prescription drugs.
For GP claims, CSO expenditure figures do not include expenses such as secretarial/nursing, annual leave, rostering/out–of–hours, medical indemnity insurance, rural practice, study leave, sick leave, maternity leave/paternity leave, locum, and practice expenses .The figures in this publication do not take these expenses into account as they are not featured in the data set the CSO receives from the HSE PCRS. This publication does include the following fee types: capitation, fee-per-item, and a proportion of special service and special types of consultation.
Payments to opticians and ophthalmologists are covered under the Community Ophthalmic Services Scheme (COSS). Under the COSS, General Medical Services (GMS) eligible persons have access to a range of treatments and clinical procedures. All claims under the COSS are processed and paid by the PCRS.
Payments to dentists are covered under the Dental Treatment Services Scheme (DTSS). Under the DTSS, General Medical Services (GMS) eligible persons have access to a range of treatments and clinical procedures. Dentists may also prescribe a range of medicines to eligible persons. All claims under the DTSS are processed and paid by the PCRS.
Please note that in this publication, average figures were calculated from actual figures not rounded figures.
GMS Scheme Persons who are unable without undue hardship to arrange general practitioner medical and surgical services for themselves and their dependants are eligible for the GMS Scheme. Drugs, medicines, and appliances approved under the Scheme are provided through Community Pharmacies. In most cases the GP gives a completed prescription form to an eligible person who takes it to any Pharmacy that has an agreement with the Health Service Executive to dispense drugs, medicines, and appliances on presentation of GMS prescription forms. In rural areas a small number of GPs hold contracts to dispense drugs and medications to eligible persons who opt to have their medicines dispensed by him/her directly.
Once eligibility for a medical card is confirmed, patients are entitled to receive certain Doctor, Dentist, Clinical Dental Technician, Optometrist and Ophthalmologist treatments/services free of charge and prescribed medicines from Pharmacists. Since the 1st October 2010, an eligible person who is supplied a drug, medicine or medical or surgical appliance on the prescription of a Registered Medical Practitioner, Registered Dentist or Registered Nurse Prescriber is charged a prescription charge by the Community Pharmacy. From the 1st November 2020, the prescription charge is €1.50 for each item that is dispensed, up to a maximum of €15 per month per person or family. For people aged over 70, the prescription charge is €1.00 per item, up to a maximum of €10 per month per person or family. The prescription charge is recouped by the HSE from the Pharmacy. Claims related to the medical card are included in this publication.
Persons who do not meet the eligibility criteria for a Medical Card but who meet the criteria for a GP Visit Card receive free access to GP services only. From 1st July 2015, all children under 6 years of age were granted automatic entitlement to free GP services. From 5th August 2015, all persons aged 70 and over were granted automatic entitlement to free GP services. Claims related to the GPVC are included in this publication.
Under the Dental Treatment Services Scheme GMS eligible persons have access to a range of treatments and clinical procedures comprised of Routine Treatments and Full Upper and Lower Dentures. Routine Treatments are available for all eligible persons. Dentists may also prescribe a range of medicines, as part of their treatment, to eligible persons.
Under the Health Service Executive Community Ophthalmic Services Scheme, adult medical card holders and their dependants are entitled, free of charge, to eye examinations and necessary spectacles/appliances. Claims by Optometrists/Ophthalmologists are paid by the Primary Care Reimbursement Service. Claims for spectacles provided under the Children’s Scheme are also paid by the Primary Care Reimbursement Service.
Under the GMS, GPs are eligible for a range of fees, salaries, and superannuation costs. Not all of these are included in this CSO publication. The table below is a breakdown of the payments included.
Curative treatments include the following:
Preventative treatments include the following:
Miscellaneous treatments include all miscellaneous treatments and radiographs.
The regions consist of the local health offices and are constructed as follows:
| Regions | Local Health Offices |
| Dublin Mid-Leinster | Dublin South Dublin South East Dublin South City Dublin South West Dublin West Kildare/ West Wicklow Wicklow Laois/ Offaly Longford/ Westmeath |
| Dublin North East | Dublin North West Dublin North Central Dublin North City Cavan/ Monaghan Louth Meath |
| South | South Lee Cork North Lee Cork West Cork Kerry North Cork Carlow/ Kilkenny Waterford South Tipperary Wexford |
| West | Galway Mayo Roscommon Donegal Sligo/ Leitrim Clare North Tipperary/ East Limerick Limerick |
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