Doctors’ surgeries around county are stretched beyond capacity
DOCTOR’S SURGERIES AROUND THE COUNTY ARE STRETCHED BEYOND CAPACITY AND AT BREAKING POINT, ACCORDING TO LOCAL GP’S AND THEIR NATIONAL ASSOCIATION. MARIA PEPPER REPORTS
MORALE is low among doctors in County Wexford where general practice is now at breaking point due to large patient lists and inadequate resources, according to the National Association of General Practitioners. ALMOST every surgery in the county has longer waiting times compared to five years ago with Wexford having one of the highest number of medical card patients in Ireland due to high unemployment and deprivation.
‘General practice is now near exhaustion. Patients are suffering and as a consequence GP’s are too’, said one local doctor.
A recent survey of GP’s revealed that the percentage of them reporting their morale as poor or very poor has tripled in the decade between 2005 and 2015.
Reduced GP numbers, coupled with increased demand has led to waiting times worsening, particularly in the past year since the introduction of free care to two large population cohorts, the under 6’s and the over 70’s.
‘ This has meant increased waiting times for patients to access appointments and an almost 50% increase in out-of-hours attendance in the past year in these age groups,’ said the Wexford GP.
‘ The reality is that general practice was at capacity before this contract was imposed and is now beyond capacity’.
‘ The core aim of the General Medical Service contract with GP’s is to provide care for acute illness in the community. The contract which is 44 years old requires them to be available 24 hours a day 365 days of the year.’
According to an Irish Medical Council Report published recently, there are 43 GP’s registered in Wexford per 100,000 population although this figure does not take account of doctors who are registered but not practising. The national average is 61 GP’s per 100,000 people -and even this is extremely low compared to other countries.
International best practice recommends that there should be 80 GP’s per 100,000 population.
‘In terms of distribution, Wexford will have one of the worst served counties if this trend continues. This coupled with one of the highest GMS numbers is hugely concerning,’ said NAGP chief executive Chris Goodey.
All GP’s in County Wexford provide 24/7 cover to their patients by contributing €500 each per month to have their ‘red eye shifts’ covered (12 midnight to 8 am) by Caredoc so that they don’t have to work 24 hours a day.
According to the NAGP, members are respon- sible for locum cover for annual leave and sick leave etc and also staff costs, building costs, insurance and all the other expenses a self-employed business owner has. Overheads and costs are continuing to rise and many practices are now carrying large burdens of debt.
The mounting levels of stress and isolation that GP’s are experiencing, is not enticing newly-qualified doctors to stay in Ireland or to return. Extra resources were promised but did not materialise, according to the association.
It is estimated that 915 GP’s in Ireland intend to retire or emigrate within the next three to five years while less than 40% of trainees intend to stay in the country. ‘Less than 2% see themselves working as single-handed GP principals and this has grave implications for rural areas which typically have had single-handed GP’s to date,’ said Mr Goodey.
‘Practices have had a 40% cut in their GMS income and the costs inherent in setting up and running a practice to cope with the demands of general practice now are prohibitive to many starting out.’
‘Single handed general practice is no longer an attractive option for many reasons. The difficulty in working like this is that it is now almost impossible to find a locum to cover leave be it annual or sick leave in the event a doctor gets sick.’ ‘ This is the sole responsibility of the doctor and this urgently needs to change. If not, we are increasing the already high risk of burn-out in our remaining general practitioners,’ he said. The NAGP is calling for more doctors to be trained with increased pathways for trainees and an easing of the burden of debt for new graduates. The association wants a new contract for GP’s, one that is ‘workable, flexible and viable’ along with incentives and grants towards buildings and staff costs and HSE salaried posts employing locums to cover leave for doctors to reduce unnecessary stress and burn-out. ‘Ireland spends less than 3% of its total health budget on primary care - this is totally inadequate,’ said the NAGP chief executive. ‘ The health service is totally unprepared for the projected increase in the elderly and very old population with multiple morbidities that we are not resourced to cope with. Diseases such as diabetes, COPD and cancers are all increasing at an exponential rate and GP’s are struggling to cope, with the limited numbers and resources that we have in primary care in the community,’ he added.