Prognosis not good for GP services
Dr Aifric Boylan. Photograph: Brenda Fitzsimons
For the first time in his 32 years in general practice, Dr Conor O’Neill is in “big trouble” financially and he fears that he could be one of the first of the Irish GPs forced to close their doors as a result of funding cutbacks.The National Association of General Practitioners (NAGP) has warned that 8 per cent of practices in Ireland will no longer be able to afford to operate and face closure, possibly within a year.
While the plight of the junior doctors has been well publicised, with many young doctors leaving the country rather than continue to put up with excessively long hours and dangerous working conditions, the crisis in general practice has been bubbling away quietly beneath the surface.
However, the NAGP’s launch yesterday of a nationwide patient awareness campaign entitled General Practice in Crisis, highlights the detrimental impact cuts made over the last three years under the Financial Emergency Measures in the Public Interest Act 2009 (FEMPI) are having on the ground.
Over the past three years, €160 million has been taken from general practice, equating to an average of a 33 per cent reduction of funding in income to individual practices, according to the NAGP. As a result of the latest round of cuts announced in July, many GPs say their services are now at breaking pointing and they predict serious difficulties in coping with the day-to-day running of their practices, particularly in the autumn/winter.
There are 2,728 GPs registered with the Irish Medical Council, with females representing 46.3 per cent of GPs overall, according to the latest figures.
Reality of cuts on the ground
As a result of the cuts O’Neill, who runs a sole practice in Waterford, has no money to buy new medical equipment, he may be forced to stop house calls to his most vulnerable patients and he has to personally transport bloods to the local hospital during his lunch hour because he can no longer afford a courier.
He employs a full-time secretary and more than 90 per cent of his patients are GMS patients. His gross income has been reducing since 2009 while at the same time he has seen a huge reduction in private patients, but his overheads – medical indemnity insurance, heat, electricity, staff costs etc – have gone up.
“People assume GPs are all very well off; they have no idea what’s going on. I have two children still at college and have come to the point where I have very little left over after I pay my overheads. I will be one of the first 8 per cent out the door because I won’t be able to afford to keep my practice open. I will be left with no choice but to notify the HSE that I can’t afford to practise anymore because I can’t run my practice and earn a living. Until such a time as my outgoings are greater than my incomings, I will keep going but when that day comes, which may be very shortly, I will have to quit and I certainly won’t be the only one.”
O’Neill, who is 62, says he has to consider the impact of this pressure on his own health. He points out that there are GPs in this country taking their own lives because of the stress they are under and the saddest part of it all is that until now, general practice was the only part of the Irish healthcare system that worked well.