Jerry Cowley, a Mayo GP who became an Independent TD in 2002 after he became infuriated by the standard of medical care in rural Ireland, stood in front of 450 people in Corofin Hall, who had braved relentless rain and rising floods.
“I’m very proud to be here and to hear my colleagues speak so passionately. Rural Ireland is alive. You’re not going to leave it die,” he told the “No Doctor No Village” campaign. His comments were met with thunderous applause.
The audience groaned in the face of promises from local Fine Gael TDs Pat Breen and Joe Carey, who insisted that pledges made by Minister for Health Leo Varadkar to keep country GP practices open would be honoured.
"The HSE has worked on a proposal that will be put to the Irish Medical Organisation in the coming weeks," declared Mr Breen. His audience was not reassured.
A man in the audience responded: “These terms mean nothing: ‘in the coming weeks’, ‘going bloody forward’, ‘the next few weeks’. I’m a patient of Co Clare. We have the power of vote.” Turning around, he asked those intending to vote to stand up. Not a single person was left sitting.
‘We couldn’t get anyone’
Cllr Pat Hayes (FF) represents Feakle in Co Clare, which has had no doctor for the past year: “We couldn’t get anyone to apply for it. Then we even offered the premises rent-free for a year. We still couldn’t get anyone. We advertised three times,” he said.
Clare GP Liam Glynn, who chaired the meeting and is one of the doctors behind the "No Doctor No Village" campaign, said 30 communities were without a full-time GP and had a locum service.
“I saw 54 patients in surgery today, everything from a dislocated shoulder to depression. We recognise knowing the person who has the disease is as important as knowing the disease that has the person,” he said.
Some rural GPs’ allowances have been cut in half: “We do not have to wait for the negotiations to finish for these allowances to be reinstated. They were changed overnight. They could be reinstated in the morning if the will was there.”
Doctors receive €9 a month for each medical card patient. Some might have a few appointments a month: “A busy practice does not mean a viable one. GPs are going to work in the UK during their holidays as a locum in order to keep their Irish practices open,” he said.
Speaking later to The Irish Times, Chris Goodey, chief executive of the National Association of General Practitioners, said: "One doctor does it every month. He goes to Scotland and gives up his weekend. It's purely financial as his practice is losing money," he said.
Dr Cowley was a TD for five years until he lost his seat in 2007. If the GPs’ allowances were not restored within a fortnight, Dr Glynn said, the GPs in Clare would follow Dr Cowley’s path. GPs in other counties might do the same.
Galway-based GP Martin Daly, who has been one of the IMO's negotiators with the HSE and Department of Health since last August, challenged the TDs' view that rural allowances would be reinstated.
The department and HSE wanted to centralise services, not disperse them. “It’s a means of diverting attention . . . to throw out these promises at the time of an election.”
Most of the future successors to rural GPs would not get the rural practice allowance – once worth more than €20,000 a year, but now worth €16,000, he argued.
“Those communities, like Bansha, getting half of a GP rural practice allowance, it’s still simply not viable to run a practice,” he said, insisting that people living in rural Ireland were “continuously let down”.
A number of other public meetings, organised by the "No Doctor No Village" campaign or by groups linked to it are due to take place in Galway, Wexford, Kerry, Donegal and Tipperary in the coming weeks.
A spokesman for the Minister for Health told The Irish Times rural practices were at the top of his agenda, and that "options being considered" included reforming allowances.
He also clarified which services medical card patients were entitled to avail of without charge.
Just 20 of Ireland's 2,500 General Medical Services contracts were vacant, he insisted. "Fifty per cent of the 20 permanent vacancies are recent and have occurred in the past six months," he said.