Minister for Health Stephen Donnelly has accused doctors attending the Irish Medical Organisation annual conference of a lack of balance in their analysis of the health service.
Speaking at the IMO’s conference in Killarney, the Minister also pushed back at doctors’ reservations over the new consultant contract and the planned extension of free GP care to over 500,000 additional patients.
Mr Donnelly urged delegates to remind themselves of the progress being made in reforming the health service. “Yes, there are parts of our health service that need urgent attention,” he said, referring to the focus of the conference on the “crisis in capacity” in the health service and challenges for patients.
“What didn’t get the same attention was the fact that we are in the middle of the biggest expansion of healthcare capacity probably in the history of the State,” he told the conference.
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Mr Donnelly said he had reviewed three of the presentations made at the conference on Friday, on cancer care, emergency departments and general practice. “Between them there was just one slide, in the cancer care presentation, recognising any of the capacity increases achieved. More beds, more doctors, more nurses, more community care than at any in the history of the HSE, and none of that got so much as a single line in a conference on capacity.”
“We need a little bit of balance,” he told delegates.
Referring to US President Joe Biden’s recent visit to Ireland, he urged doctors to “take a lesson from a remarkable and proud Irish American president, and remember that together in Ireland and in healthcare, we have done a lot, and are more than capable of tackling what lies ahead”.
In a lengthy and at times combative address, Mr Donnelly stoutly defended his plans to extend GP visit cards to over 500,000 additional people, in the face of ongoing opposition from family doctors. “Right now, as so many across the country are challenged by the cost of living it is important that we make progress. Right now, there are patients who are putting off seeing their doctor because they cannot afford the fees.”
“I want to acknowledge the very real concern GPs have in terms of ensuring you have sufficient resources to deal with the additional visits these cards will create. While many GP practices are thriving, others are under intense pressure, particularly in some rural and urban areas. So I want to acknowledge that this is a big ask of general practice. ”
[ Patients to wait ‘weeks’ for doctor visit if free GP care extended, union warnsOpens in new window ]
Mr Donnelly acknowledged the expansion of free GP care will lead to more visits by patients, but rejected claims by doctors it will overwhelm an already creaking system. “I do not agree that this will ‘overwhelm’ general practice, but fully agree that the additional visits require more resources for GPs. To that end, I allocated tens of millions of euro in the budget for this year specifically to provide new support to GPs.”
“My Department is in intensive engagement with the IMO on the new GP cards and new supports for GPs that must accompany them.”
He described the new consultant contract as a good compromise that will set the stage for a big increase in consultant numbers, but criticised “misleading information” about it (though not from the IMO). Including allowances, it will give consultants salaries of over €300,000 and allows “unlimited” private practice in private hospitals, he pointed out.
“I have no doubt but that this misleading representation of the contract contributed to the number of consultants expressing concerns about it. This is a real pity, as it damages the HSE’s ability to hire into these badly-needed roles.”
The new contract will not result in excessive or unfair demands on consultants to work an unreasonable number of evenings or Saturdays, he said, and consultants will not be rostered for duty without adequate support. “A consultant’s work location will not be changed without engaging fully with the consultant and/or the IMO. Also, any requirement to move location will be subject to the protections available to all public servants under national agreements.”
Later Mr Donnelly acknowledged the promised extension of free GP care to over 500,000 people will not take place on schedule.
GP visit cards were due to be provided to six- and seven-year-olds last December, and to people under the median household income by the end of this month, it was announced in last year’s Budget.
The Minister said he wanted the measure to be introduced in April and has told his officials it needs to happen “very soon”. He declined to specify what he meant by “very soon”.
“We want to be respectful of the IMO and GPs. We want to do it by agreement with them,” he said, speaking to reporters after addressing the conference in Killarney.
“We have got to get this right. If that means spending a short additional period of time it is worth spending that time.”
In his address, the Minister acknowledged the expansion of free GP care would lead to more visits by patients, but rejected IMO claims it would “devastate” general practice and lead to delays for other patients.
The proposal will result in an average of three to five additional appointments a week for each GP, he said.
Earlier, delegates criticised the new consultant contract being introduced by Government.
Prof Matthew Sadlier, chairman of the consultant committee of the IMO, said the Government had missed an opportunity to create an attractive common contract that would appeal to all consultants – existing and new.
Feedback from consultants around the country had identified concerns on issues such as rostering, work locations and locum support, he said.
“Many consultants do currently work in different locations and do work weekends and evenings and the issue with this contract is to ensure that there are reasonable agreements on how these matters will be dealt with in the future.”
