General Practice in County Wexford is now at crisis point

IN last week’s edition of this newspaper (July 26) the Citizens Advice Bureau advised readers to report cases where their GP was charging medical card patients for phlebotomy services.

The suggestion was that GPs are contracted to provide these services free of charge to medical card holders.

It is the view of the NAGP that the GMS contract contains no obligation on GPs to provide phlebotomy services free of charge.

The Department of Health and HSE may have a contrary view but it is the position of the National Association of General Practitioners (NAGP) that they are not the arbiters of how the contract should be interpreted.

It is also important to point out that Phlebotomy services are provided free of charge in public hospitals with a GP referral.

I understand it may have been the case that some GPs in the past did offer this service free of charge to medical card patients as a gesture of goodwill. However, general practice in this country, particularly in areas of the country with a large number of Medical Card patients, such as Wexford, is at crisis point.

The expansion in demand for GP services is, in large part, due to the increase in the number of Medical Card patients, now approaching 50% of the population since the introduction of the under-6s scheme. A further 50,000 patients were added when the over-70s scheme was introduced. While the number itself is significant, this demographic of the population comprises patients who also require the most acute care.

During the period of rising Medical Card numbers, Financial Emergency Measures in the Public Interest (FEMPI) has reduced the price paid per consultation by almost half, with an ever-increasing cost base to those providing the service. The combination of increasing demand for services and a sharp cut in resources through FEMPI legislation has left the sector struggling to deliver the care that Irish general practice is internationally renowned for. The number of GPs in Ireland per head of population already falls short of international norms.

General practice delivers 22 million consultations every year, which is projected to increase to 33 million within the next five years. The number of consultations provided by GPs is 10 times that of hospital attendances.

There is a huge deficit in the resourcing of general practice. It is not possible for the secondary care sector to make up this deficit. Even if it were, the cost would be crippling. GP-led primary care is the answer to many of the problems with our health service and GPs are ready and willing to be leaders in this change. General practice needs to be adequately resourced to achieve this. GPs need a new contract to replace one that is severely out of date having been drafted 44 years ago. Patients, doctors, public representatives and all our partners in healthcare need to work together to achieve the health care system we all envision. Chris Goodey, National Association of General Practitioners CEO