Breaking point for New Ross GP crisis
Patients and doctors suffering as underfunded service hits capacity
GP SURGERIES in the area are at risk of dying out due to an exodus of college graduates and impossible working conditions.
In a special report in this week’s edition, two local GPs outline the crisis in local GP care due to a combination of Financial Emergency Measures in the Public Interest (FEMPI) cuts and GPs retiring. The doctors, who have around 2,000 patients on their books each, criticise a lack of investment by Government in GP healthcare with one New Ross doctor saying she is planning on leaving the profession unless significant changes occur.
Some under pressure doctors in the area have been so busy they have been telling patients they have to wait weeks to be seen and have been telling newcomers that they cannot come under their care.
Dr Catherine O’Donoghue said: ‘It’s an absolute disgrace how GPs are being treated.’
SOME GP surgeries in the area are telling patients they have to wait up to six weeks to be seen and newcomers that they cannot come under their care.
A crisis has emerged over recent years in New Ross, which has come to a head for several GPs in the area, some of whom are considering whether or not they will be able to continue working in the profession due to increasing pressures. Dr Catherine O’Donoghue of Adamstown clinic said: ‘It’s an absolute disgrace how GPs are being treated in the way FEMPI legislation was made long term in the Dáil before Christmas. GPs have been given no hope whatsoever from our political leadership of effective improvements in our conditions.’
Dr O’Donoghue said GPs are ‘getting out’ of the profession as quickly as they can, adding that she knows of a Wexford doctor who is set to emigrate due to the pressures of the job.
‘GPs, like me, are taking to Twitter bemoaning the current state of affairs. There was a doctor in Monaghan last week who was facing in to having to tell her children that they weren’t going on their family holiday because of the shortage of doctors.’
With between 1,500 and 2,000 patients on her books, Dr O’Donoghue said she, like other doctors, would love to be able to see patients on the day they call, but often it is a number of days before they can be seen.
‘We will aim to see all acute illness patients on the day or within 48 hours but it doesn’t always happen.’
She said she would happily take on new patients, but only under strict criteria, meaning if a patient from Ballinaboola has been long registered with a doctor in Duncannon, she would not take him or her on.
Like all doctors in the area she is firefighting ever increasing mountains of work.
‘ There is zero flexibility. I am working 12 to 13 hour days, from 9 a.m. until 9 p.m. or 10 p.m.
The free GP cards for children under six and adults over 70 have affected every doctor. You also have to do paperwork. As a result you are never home to put the kids to bed. I love my job and I love the area where I work, but GPs are at their wits end due to the increased workload.’
She said despite regular communication with politicians through letters, social media etc there has been no improvement in working conditions.
CareDoc in New Ross has increasingly become the go-to place for sick people, but is not a comprehensive overnight service, as often patients are advised to wait until the following morning or to travel to Waterford CareDoc.
Dr O’Donoghue said: ‘Care- Doc should be for emergencies and if you are too sick to wait. It is open 24/7 but there won’t be a doctor on the premises at night due to resourcing issues. Waterford is only 20 miles away. I don’t think it’s an excessive distance to drive if someone has a sick child and they will get an appointment there.’
The fact that doctors are effectively proposing up CareDoc by paying €6,000 ‘for cover’ as they can’t be available 24/7 is another slap in the face to doctors, many in the profession believe.
‘We are expected to provide 24 hour care, 365 days a year. It’s one of the things the Government need to address. The damage of the past ten years had damaged the vocation-ism of GP’s considerably. There are too many demands are being made of doctors. Trying to get a locum is extremely challenging, if not impossible. If I am sick in the morning and can’t get a locum do I come in sick or do I close my doors for a few days.’
Dr Nanette Boyle said: ‘Most of the practices in the town are at full or close to full capacity. It’s a culmination of factors including significant cuts to HSE payments to GPs during FEMPI and GPs retiring.’
Dr Boyle said emergency cuts introduced under FEMPI have
not been reversed, meaning fewer and fewer trained doctors are entering general practice across the country, including in New Ross, opting instead to work abroad, where they are far better remunerated.
Dr Boyle, who practices at Priory Place, said the Government’s decision to issue free GP Visit cards for children and adults aged over 70 has sparked a significant increase in patient footfall at doctors’ surgeries in the area, and nationally.
‘ The reality is that when there is no fee at all, then people have a lower threshold for attending their family doctor. And the possibility of more doctor visit cards for other age groups is a worry in the context of no additional resourcing to general practice.’
Dr Boyle previously worked alongside Dr Terry Roger’s practise for about ten years, before taking over the practise two years ago.
‘It’s getting busier all of the time. I have between 1,000 and 2,000 patients in total. There is enormous paper work with the job. It eats into personal and family time.’
Working from 9.15 a.m. until up to 7.30 p.m. five days a week, along with CareDoc work, Dr Boyle’s schedule is replicated by her colleagues across the district.
Dr Boyle said the crisis has led to an overflow of patients into CareDoc which operates from 6 p.m.
‘We try to see what we would regard as emergency cases on the day they call. These include sick children, elderly people and those with acute illnesses. Otherwise we try to offer an appointment the next day or subsequent day and we manage to do that as much as we can.’
The winter poses a particular problem as there is a huge demand for flu vaccines and an influx of patients with flus and other ailments.
‘We can’t offer the service we would like in the winter due to the footfall. We are only just about able to deal with patients’ urgent needs – so providing holistic GP care is aspirational at best.’
The slashing of GP’s pay has made the profession far less attractive to graduate doctors, while a change in tax arrangements for foreign locums to work in Ireland has also made getting cover increasingly difficult for GPs like Dr Boyle.
‘It’s really difficult to get a locum or someone to cover for you regularly or if you need a day off for educational or family reasons. General Practice in Ireland is not as attractive to people anymore. A lot of students go abroad once they qualify so Irish graduates are in short supply. We are at crisis levels. I am thinking about my future and how to get out when I decide to. I need to make a pathway for that.’
Dr Boyle said in the past a GP would usually have had an incumbent willing to take over the practice but now this is no longer the case. ‘ There is noone here to take this.’
Such is the crisis in some surgeries that it would take-up to two years to transfer from a GP in another town to a GP in New Ross. Dr Boyle said there is currently no room in the surgery for newcomers to the area, whether GMS (medical card) or private. She said the downside of providing free GP cards for children and adults is that GP surgeries are packed, with phones hopping, from Monday to Friday, causing an overspill into CareDoc, based beside New Ross Community Hospital. ‘ There is an overflow of non urgent matters. This is leading to a total misuse of the service. For some people it suits them to use CareDoc as they may be working but the service is undoubtedly under strain and there are issue around continuity of care. Unless there is a major injection of personnel and money General Practice won’t survive as it is currently.’
MOST PRACTICES ARE AT FULL CAPACITY. I AM THINKING ABOUT MY FUTURE AND HOW TO GET OUT WHEN I DECIDE TO