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Newly-released HSE figures show that 115,262 GP consultations for asylum residents and Ukrainians took place between January 2024 and November 2025 – with Carol Nolan TD commenting the data exposes “enormous pressure on already overstretched local GP services”.
She was also sharply critical of the lack of transparency around healthcare provision in relation to migrants and asylum seekers – and strongly disputed what she described as a line “parroted by NGOs” that high levels of immigration had no impact on service provision.
The HSE told Deputy Nolan, in response to a parliamentary question, that the HSE Refugee and Applicants Seeking Protection (RASP) Service Delivery Model was developed in 2022 in response to the arrival of displaced Ukrainians coupled with a surge in asylum applicants. The model, the HSE said, sought to support equitable access to health services for those migrant populations.
Amongst the health services provided are initial in-reach engagement with newly arrived residents, including triage; support with Medical Card Application forms and linkage to local GMS GPs and GP Sessional Clinics as required; and Infectious Disease testing.
GP sessional clinics are not assigned to individual IPAS centres, as they operate on a regional, needs-led basis across multiple locations, the HSE said.
Independent TD for Offaly, Carol Nolan, said the newly released HSE figures showing 115,262 GP consultations “expose a system that is placing enormous pressure on already overstretched local GP services”.
“When more than 115,000 GP consultations are being delivered in less than two years, and when those clinics are being staffed by the very same local GPs who are already struggling to meet the needs of their own communities, then it is absolutely clear that the Government has created a parallel healthcare system that is completely unsustainable,” said Deputy Nolan.
“Every hour these doctors spend in a sessional clinic is an hour not available to their own patient lists. That is the reality the Government refuses to acknowledge. Is it any wonder that people in Offaly and the midlands are now routinely waiting weeks for a local GP appointment,” she said.
LACK OF TRANSPARENCY
Deputy Nolan said her PQ’s also expose a complete lack of transparency around healthcare provision in IPAS centres as the HSE was unable to provide a centre‑level breakdown of demand, despite the scale of the GP activity reported.
The Offaly TD also highlighted the HSE’s admission that no review has ever been carried out on healthcare staffing adequacy, continuity of care, or emergency response capacity in IPAS centres:
“These replies totally obliterate the nonsensical line that has been parroted by NGOs, and indeed very many politicians and commentators, that there has been no meaningful impact on service provision following the extraordinarily high numbers of people who have entered the country for no legitimate reason in the last number of years.”
“I will continue to shine a light on these issues, because I am absolutely convinced that a massive ‘perception fraud’ has been perpetrated on the Irish people,” she said.
“They have been told to ignore the reality they see with their own eyes or at the very least, they have been told to shut up and don’t talk about it. That level of egregious gaslighting is coming to an end, because I for one will not tolerate it,” said Deputy Nolan.
STRAIN ON LOCAL GP CAPACITY
In November 2022, Dr. Mary Ryan a consultant working in hospitals in both Limerick and Kilkenny, told Tipp FM that Ireland needs to pause accepting migrants and refugees because the health system cannot cope.
Dr Ryan said that there was a risk of “giving a bad service to everyone” when the system becomes overloaded, and called for a “pause” in accepting refugees because the system was so far behind, especially after major delays in screenings and treatment for cancer as a result of the Covid lockdown.
“There is a backlog in diagnosis … about 1 in 2 people are going to be delayed in diagnosis and treatment,” she said, pointing out that “we need to get on top of what we have.” Catching cancer early was key, the consultant pointed out.
She also told Tipp FM that the refugee crisis was compounding the crisis in the health services. “We have 62,000 [extra] people in,” she said, adding that a “helicopter view” was needed to assess what the country can deliver, or the crisis would get worse while the health service was “back peddling”. “There is no point giving a bad service to everyone,” Dr Ryan said. “We have to look after our own people as well as refugees … but in order to do that we have to provide a proper service .. we should not provide a sham service.”
“We are welcoming the refugees and we are very good to them, all I am saying is we need to take a breather and do the helicopter view on what we have at the moment and how we can look after all those citizens Irish, Ukrainians, Syrians all of those who have come in, in the proper manner. We are already so far behind before we start taking more in.”
She disagreed with statements made by an Taoiseach at the time who said that Ireland could not limit how many refugees came to the country.
“I didn’t agree with Michael Martin when he was saying they can keep coming, I can see services stretched. I am the doctor, I can see this,” she said, calling for a proper assessment by the government of what medical services the State was capable of offering.
In January 2023, a Department of Health report highlighted that the “uneven geographic spread of refugees is causing a significant strain on local GP capacity”.
The Dáil heard last November that a total of €174 million has been made available for the provision of healthcare services for refugees and migrants since 2022, including €50 million for 2025.
However, this week, it was revealed that over €100 million has been spent on medical cards for Ukrainian refugees living here since 2022 – with almost €34 million spent last year on medical cards for that cohort alone.
A further 21,500 people, who were granted or were seeking asylum in Ireland, were issued medical cards or a free GP visit card through the health service last year.
The figures were released in response to a parliamentary question by Fianna Fáil TD Albert Dolan by the Primary Care Reimbursement Service, which oversees medical card approvals,
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