Students need incentives to work as rural GPs, says report

Students from rural backgrounds should have financial incentives to train as GPs working in country areas, says a report.

Medical students could have with scholarships or education loans linked to service after training to encourage more doctors to work in rural general practice, according to the Irish College of General Practitioners (ICGP).

It says rural GPs urgently need support for premises and out-of-hours services in order to stop the flight of doctors from more remote parts of the country. Doctors with smaller lists could be given premises rent-free.

“Rural Ireland will be left without GPs if nothing is done, and elderly people will have to travel long distances for medical assistance, often having to rely on non-existent public transport,” says Dr Margaret O’Riordan, medical director of the ICGP and report author. “It has happened in other countries, so why shouldn’t it happen here?”

Hard to fill posts

The report shows that by last May, there were 21 vacant medical card lists around the country, half of them in rural areas. Over 22 per cent of the unfilled posts were vacant for over two years, though all were serviced by locums.

Rural general practice has fared worst in attracting new GPs and finds it increasingly difficult to source locums to provide cover, it says.

For example, in Gortnahoe, Co Tipperary, the HSE advertised twice for a successor to the GP, who was retiring, without success. He has now taken on the post as a locum, despite being over retirement age.

Off-shore islands

In Feakle, Co Clare, a largely older population has to travel substantial distances after repeated efforts to fill the GP post failed. Moycullen, Co Galway, hasn’t had a permanent GP for seven years, while Borrisokane, Co Tipperary, hasn’t had one for two, says the report.

It also says the unique challenges and difficulties faced by GPs servicing off-shore islands must be addressed. Ten GPs provide medical services for 2,400 residents on 10 of the 26 offshore inhabited islands. There are resident doctors on Aranmore, Inis Mór and Inis Meain, while the others are serviced by visiting GPs.

The higher age profile among rural doctors gives urgency to the situation. Nationally, one-fifth of doctors are 60 or over and a third are over 55. However, in Co Mayo, more than half of GPs are over 55.

The report says the Government’s plan to develop large primary care centres across the State will not be viable in rural areas, where only 7 per cent of patients live within walking distance of their GP.

The report says rural practices suffered disproportionately from cuts during austerity, in particular from the “arbitrary and unilateral” removal of the rural practice allowance. In north Connemara, for example, a practice with a large, dispersed population is unlikely to be able to continue because of this. “Not alone will this result in the loss of the GP and his practice, but patients will have to make a 50-75km round trip . . . in an area with poor public transport.”