No increase in family doctor numbers despite cuts reversal

There has been no increase in the number of family doctors since the Government agreed a deal earlier this year to roll back austerity-era cuts to general practitioner services, latest figures show.

The number of GPs signed up to a scheme to provide services backed by the Government such as care to patients with medical cards has remained static at just below 2,500.

This is despite a €210 million agreement last May with GPs to restore funding cuts introduced during the recession and introduce new services for medical-card patients with chronic illnesses such as diabetes or cardiovascular conditions.

There are currently 2,498 GPs signed up to the Government scheme, which represents the vast majority of family doctors. This is an increase of just a handful of doctors compared to the 2,491 GPs practicing at the start of the year.

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Dr Denis McCauley, chair of the Irish Medical Organisation (IMO) subcommittee for GPs, said the agreement to reverse the previous funding cuts was not a "bonanza" for local doctors.

Rural services in particular had been stretched thin over the past decade, and as a result “the concept of the same-day service disappeared” and increasingly doctors’ patient lists became oversubscribed, he said.

“The ship was sinking, we now have a pump to stop the water getting in. We don’t have a new ship,” Dr McCauley told The Irish Times.

“There are not enough young GPs on the ground to cover the GPs that are leaving, young GPs are going abroad.”

Particularly challenging

Rural practice was particularly challenging due to a lack of rota and out-of-hours support for family doctors, he said.

Current demographics showed large numbers of local doctors were due to retire in the next five years, which could leave rural communities without GPs if more support was not provided by government, Dr McCauley said.

In the past family doctors would have taken on an assistant who might go on to take over the practice when they retired. “In recent years that didn’t happen because GPs couldn’t afford to take on doctors,” he said. Single practice patient lists in rural communities were often “very unattractive” for young doctors to take over due to the workloads, he said.

Dr Pat Morrissey has a practice in Adare, Co Limerick and is also the chair of Shannondoc, an out-of-hours GP collective in the Shannon region.

“Single-handed practice which was the backbone of rural GP practice for a long time is getting tougher,” he said.

Several doctors in his area had closed their lists and could not take on any more patients due to existing workloads. “I’m not at that level yet, but it is increasingly common,” he said.

“Young GPs are starting to go to larger towns and cities to avoid excessive out-of-hours work.”

Rural communities

The result would see more and more rural communities losing their local doctors in recent years, which would have a much greater impact than losing services such as the post office, he said.

A spokesman for the Department of Health said the “Government is aware of the many challenges facing general practice in Ireland, including in rural areas.”

Health officials recently became aware of problems GP out-of-hour services face recruiting locum doctors from abroad due to certain immigration restrictions, he said.

HSE officials are currently working with Department of Justice immigration officials and “are confident that a solution can be found to this problem”, the spokesman said.