Rural doctors: The GP who goes to work on a currach

Noreen Lineen Curtis uses a currach to travel to visit patients on tiny Inisbiggle Island off the Co Mayo coast.

Once every three weeks, in all seasons, Curtis heads out in the small craft to service the health needs of the island’s 16 inhabitants.

Nor is this the only island where she works. At least in the case of Clare Island, which has a population of 160, a modern boat is available to ferry her back and forth.

Working on offshore islands is only part of the huge variety in Curtis’ practice, which is centred in Achill. There are three full-time doctors and one part-timer in the group practice, and all of them eat up the miles during the year serving the needs of a widely dispersed and ageing population.

Personal relationship

This is primary medicine of a kind that has disappeared in many more populated areas. With little in the way of back-up or alternatives, the relationship between doctor and patient is intensely personal and is not confined to the GP’s surgery or regular office hours.

Typically, she’ll work Monday to Friday, be on call one or two nights a week and work one weekend in four.

“There are a lot of house calls, and you’re on the phone 24/7. In other parts of the country, you might get back-up from an out-of-hours service but that’s not an option here and we just do it ourselves.”

Curtis bristles at what she believes are the huge inequities in the way rural GPs are treated. The removal of the rural practice allowance and the elimination of distance-related fees for services such as house calls has hit hard. “I could do a 30km round-trip in the middle of the night, in the pouring rain, and I’m treated the same as a city doctor who rolls out of bed and walks to a patient next door.”

She says the HSE tried to remove her island contract which was retained only after a legal battle. “It’s all they’re thinking about now, cutting money and doing things cheaper. But you can’t treat islands the same as other parts of the country: there are extra costs involved.”

At 45, Curtis is the youngest member of her practice, where her father still works part-time, despite being past retirement age. As the mother of four schoolgoing children, she’s well aware of the implications of being a rural GP for family life; it helps that her husband, a non-medic, works part-time.

The villages and small towns where she works have already lost many other local services – post offices, Garda stations, shops – and Curtis fear GP surgeries could be next.