FAMILY DOCTORS' CONFERENCE:FAMILY DOCTORS have strongly criticised HSE plans to create a network of community-based primary care teams throughout the State, with a leading GP describing the team of which she was a member as "irrelevant to my practice".
Speaking during a debate on the future development of general practice and primary care, Dr Mary Favier, a Cork city GP and member of the executive of the Irish College of General Practitioners, told doctors attending its annual meeting in Galway she was part of a non- functioning primary care team.
She said her group practice was part of a HSE "virtual" primary care team, whose members has met just once since it was set up some years ago. Without proper engagement from the HSE, she said family doctors would continue to provide services to patients, while the HSE would continue to "exist on the periphery of our working lives".
While welcoming an earlier presentation by Brian Murphy, national primary care services manager with the HSE, she complained she had heard it all before when primary care teams were first proposed some 10 years ago.
Mr Murphy told the meeting that the ultimate aim was to have 530 primary care teams throughout the Republic. "Some teams are working well, but some HSE staff are not yet up to speed with what is needed," he said in reference to the 110 teams currently in place. The national primary care manager said some 300 new clinical staff has been assigned to teams and there were plans to "reconfigure" 3,500 existing frontline staff so that they would work as part of a primary care team. He also promised 200 primary care centres, built through public-private partnership.
Speaking to reporters, ICGP chairman Dr Mark Walsh accused the HSE of an "ongoing PR deception" in relation to primary care teams. Its chief executive, Fionán Ó Cuinneagáin, described the HSE concept of community-based teams as virtual rather than real. Asked how the 8 per cent cut in practice allowances paid by the HSE to cover some of the cost of employing practice nurses and administrators - announced by Minister for Health Mary Harney last week - would affect patient services, he said that while redundancies for practice staff were unlikely, doctors would have to look at cutting staff hours of employment. He warned that general practice faced a pincer movement with an increased demand for GP services and reduced funding.
Meanwhile, David Price, senior research fellow in international public health policy at Edinburgh University, spoke of the damage done by the centralisation of general practice in parts of Britain.
He told doctors there was no longer a contractual relationship between GPs and the state in England. Instead, commercial providers were able to negotiate formal contracts with the National Health Service which allowed for an "unbundling" of services so that GPs could no longer provide an integrated and comprehensive service for patients.
Mr Price criticised the lack of evidence for this reform and suggested that the drive for shareholder return generated "new cost pressures" which threatened the important dividing line between business and the clinical care of patients. He said there was a real risk that the cuts demanded by a commercial approach would be borne by "the old, the poor and the chronically sick".