THE CRISIS IN WEXFORD GP PRACTICES
In this submitted article, local GP Catherine O’Donohoe says the government is turning a deaf ear to the concerns of doctors
A FRIEND once told me of his father bringing him to Dublin the day of a farmers’ march when the late Taoiseach Charles Haughey was Minister for Agriculture; my friend’s father told him that day that the Minister should have listened to the farmers. That appears to have been 1966. The following year after further industrial action, some 80 farmers were imprisoned in Mountjoy and Limerick jails.
GPs in 2018 have every reason to be concerned that they are not being listened to by the Minister (for Health), or his colleagues, the Minister for Finance, and Taoiseach Leo Varadkar – who is a qualified GP.
FEMPI (Financial Emergency Measures in the Public Interest) was the series of cuts made by Irish governments from 2009-’13 in order to stabilise public finances after the banking crisis. The cuts sustained by general practitioners were among the highest sustained by any group of workers in the State - more than 35 cent in every euro before tax, and before the cost of running a business was taken into account.
Last November, Finance Minister Paschal Donohoe told the Dáil that ‘our teachers, nurses, gardaí and other public servants and their retired counterparts’ both deserved and were legally entitled to pay (and pension) restoration as FEMPI had happened because of the financial emergency from which we have now emerged.
However, he then said a different approach was to be taken for those who are contracted by the State to provide services – which includes GPs: ‘Part 5 places certain provisions of the Fempi legislation on a permanent, non-emergency footing.’
How can emergency legislation be made permanent for this last grouping if the emergency is over and all other groupings affected are having the emergency measures lifted?
It is common knowledge in our communities that General Practice services have been damaged significantly by FEMPI.
Yet, GPs have been told on numerous occasions recently, including by the Taoiseach, Minister for Health, and Minister for Finance, that they will effectively need to work harder to get FEMPI monies back.
Most of my colleagues would wonder how much harder we can work.
Does the current crisis in General Practice not underline this? There has been significant coverage in the media, and also on social media, regarding the difficulties currently faced by people trying to register with GPs in many areas, including but not limited to Carlow, Monaghan, Kildare, Carrickmacross, Leitrim, Naas, Clare, Bray and Cork.
The town of New Ross and its hinterland is one area of our own county where there is significant difficulty.
It was announced in April that MIDOC (the Midlands equivalent of Caredoc) has had its centres in Birr and Edenderry close with now only one Offaly centre in Tullamore.
This is not an isolated concern. A meeting was scheduled for mid-April by the HSE in Bray to look at planning for the Out of Hours Services for North Wicklow/South Dublin going forward.
Will more counties have their GP Out-of-Hour services similarly affected in the next 12 months? (As an aside, it is probably not widely known that I and all my GMS colleagues in Wexford pay €6,000 annually to Caredoc to fund the overnight service).
This is the reality that we now have. Add into this the Irish Medical Organisation expectation that 26% of GPs in Wexford are due to retire in the next 5 to 7 years. There should be no doubt in anyone’s mind- citizens/patients or our public representatives that if FEMPI is not reversed promptly for General Practice, this is only going to worsen.
This crisis is no longer about GPs; it is about our country’s General Practice services.
It is actually illegal for GPs as a group to organise a strike, so GPs are unlikely to be found striking as they don’t want to end up in prison like the farmers in the 1960s!
However, knowing that GPs can’t strike and at the same time telling GPs to work harder without an immediate reversal of FEMPI (#reverseFEMPI on Twitter) shows a serious disconnect between our political decision-makers and the experience at grassroots of both GPs and the general population.
It is also crazy as most GPs I know aren’t able to work any harder at this point in time. Will more towns need to be in difficulty with their GP services before this is accepted? What about patients being discharged from hospitals to nursing homes. If overstretched GPs are less able to provide care in nursing homes, how will this affect the bed crisis in our hospitals?
How much worse will this get? With it being recognised this spring that patients are attending A&E because of difficulty accessing a GP appointment, it is essential for the wider functioning of our Health Service that action is taken now by the relevant Ministers. There is no point in talking more about replacing our GP contract that is over 40 years old without stopping the ongoing weekly damage to General Practice that is happening without the reversal of FEMPI.
Finally, it should be noted that a significant number of jobs are provided in GP surgeries nationally. A quick email survey with Co. Wexford colleagues for this article shows that there is a minimum of 200 jobs in GP surgeries in Co. Wexford, with a number of surgeries contracting out services such as cleaning. The possibility of GPs running in the next general election has been openly referenced on Twitter in the last few months. My hope is that that we will see action on #reverseFEMPI for General Practice by July 13, ie the Dáil Summer recess; and that GPs will be left doing what they do
best- General Practice.