West coast general practitioners like Dr Mary Rogan and Dr Jerry Cowley know how deserving carers are of any sort of support, but they are worried about the impact of the promised new GP cards for them.
“They are so dedicated, work so hard, are so constrained as to what they can do in their own lives and it is like no other job,” Dr Cowley, based in Mayo, says.
Dr Rogan, who runs a practice with a mix of medical card and private patients in Annaghdown, outside Galway, concurs.
However, both agree a bit of consultation with GPs in advance by Minister for Health Simon Harris would have been no harm.
That consultation might have involved “reminding the Minister of the need for resources”, they point out.
Like many rural GPs, both doctors are stretched by multiplying demands and less money for same – the latter borne out by the recent report published by the Department of Public Health and Primary Care at Trinity College Dublin which found just 4.5 per cent of the total health budget is spent on payments to GPs.
Mr Harris's pledge this week to provide 40,000 carers with free visits to GPs has been dismissed as a "vote-buying exercise" by the National Association of General Practitioners. And the Irish Medical Organisation said the Government's plan could not go ahead without negotiations and the provision of adequate resources.
“Where carers need a GP card, there is every reason that they should have it, but Mr Harris needs to introduce some fairness into the system,” Dr Cowley says.
“At the moment, the most vulnerable in our society are the ones suffering as a result of the Fempi [financial emergency] legislation which introduced cutbacks, such as house calls outside a three-mile range.”
He says it was predicted introducing free services for under six-year-olds would put considerable strain on GPs, “and it has”.
“Rural GPs cannot supply certain medicines to many of their patients, and it is for this reason that there are now about 64 rural doctors left, compared to 250 some years ago,” he says.
“The result of all this is the elderly people forced into emergency departments and on to trolleys if they are lucky – because the resources for primary care in the community are not there.”
“It reflects lack of common sense and joined-up thinking and the people in most need are hurting most.”
Dr Rogan agrees Fempi cuts had affected many GPs, and two doctors who had retired near her in Headford, Co Galway, had not been replaced.
“No one would dream of begrudging carers a support like this, but I am not aware of any consultation by the Minister’s department beforehand with the unions.”
“This may not increase the workload in the same way that it did when the scheme for under six-year-olds was introduced, but we wonder what is to follow – free services for under 12-year-olds and for over 65-year-olds, without the financial support to back it up.”
Dr Rogan notes parents who could not get time off work were bringing children with GP cards to out-of-hours services, where their children were seen by a locum who might not have been furnished with adequate notes or background on allergies and other conditions.
“It makes the out-of-hours work even more difficult for GPs, and it may not be the best outcome for everyone concerned,”she says.