There is an immediate need for an increase in general practitioner numbers, a leading GP has said.
Dr Richard Brennan, chairman of the Irish College of General Practitioners, said yesterday: "If general practitioners get too busy - and they are already very busy - the care of chronic diseases and psychological problems will suffer, and referral rates to secondary care will rise."
Addressing the seventh annual health conference run by the Centre for Insurance Studies at the graduate business school at UCD, Dr Brennan noted that GPs had a "gatekeeper" role at present, which minimised the number of people requiring treatment in the hospital system. But he warned that even a minor increase in GPs' referral rates could swamp the secondary care sector.
Referring to the increasing number of older people in the population, he said this group of patients had higher consultation rates and increased treatment costs which were directly related to the amount of chronic disease they suffered.
Only a third of graduates from family doctor training schemes worked full-time in general practice. "We need to train 150 GPs a year and require over 1,500 family doctors to meet our 10-year needs," he said.
He also questioned whether the healthcare needs of the Republic's multicultural society were being met. "We must prepare to better integrate people of different ethnic backgrounds into our health service". He also called for better links between the departments of Health and Justice to help the assimilation of recent immigrants into Irish communities.
Referring to the present controversy over certain local hospitals in the State, he said: "Communities have concerns when they see their local hospital being downgraded. We must be able to offer them enhanced primary care services if this happens."
Earlier, Mr Aidan Punch, senior statistician at the Central Statistics Office, told the meeting that the provisional results of the 2002 census indicated the population had increased by 8 per cent in the six years since 1996.
He predicted a future annual population increase of around 23,000 people, or half a per cent, based on migration and birth patterns. "There has been no change in the number of deaths which remain at 30,000 to 33,000 per annum," he said.
According to Mr Punch, one of the strongest predictions concerns the number of older people in the population. "The over-65s will more than double by 2031, with their numbers increasing from 414,000 to 840,000 people during that time."
Dr Mary Codd, consultant epidemiologist at the Mater Hospital, Dublin, said the big change in the number of older people meant their needs could not be ignored when the demands on acute care were being considered.
"At present the over-65s occupy 46 per cent of all acute hospital bed days in the State. We simply need more capacity right across the system," she said.