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GPs are sick of constantly having to say sorry

Doctors are fed up with being in frontline of our dysfunctional health service

The dwindling number of GPs delivering this service are too stressed, burned-out, starved of staff and access to supports for patients. The entire GP system is on the verge of collapse. File photograph: Alan Betson

Why are GPs protesting outside the Dáil today?

It’s because we are fed up being in the frontline of our dysfunctional health service and are sick of saying sorry to patients for all the things we can’t provide.

If general practice is to continue to deliver a service that our patients deserve it is critical that we have appropriate resources along with access to local services.

Patients depend on general practice as the main access point to the entire health service. The majority of first contacts with the health service occur in our consultation rooms. Just 3.5 per cent of the total health budget goes to general practice. The dwindling number of GPs delivering this service are stressed, burned-out and starved of staff and access to supports for patients. The entire GP system is on the verge of collapse.

Some 70 per cent of practices are closed to new patients, dozens of communities are now without a GP, with waiting lists in many areas for appointments. If your family can no longer access a good GP service, what is the alternative?

We are tired of having to apologise for our two-tier system. We didn’t create it

We are tired of saying sorry. . .“Sorry we are not taking on new patients, we don’t have enough time for our existing patients.”

“Sorry we can’t give you a same day appointment. Please go to the emergency department.”

“Sorry your village no longer has a GP, the job is so unattractive that no GP wanted the position when your GP retired.”

“Sorry I can’t do house calls as I’m just too busy in the surgery, and the HSE funding for home visits has been withdrawn. Perhaps a HSE nurse can go instead. You should phone your TD to see what services are funded locally.”

“Sorry you have to pay extra for bloods. The current GP contract is 48 years old and not fit for purpose.”

We should not have to apologise on behalf of the HSE . . . “Sorry, you have to wait two years for an outpatient appointment.”

“Sorry I have to refer you to the emergency department as it’s no longer safe to wait two years, please ensure you bring snacks and a book as it may take 10 hours.”

“Sorry that I can’t refer you for free counselling services, this is only available for medical card patients. Your GP visit card gives you zero entitlement to the other services you need.”

We are tired of having to apologise for our two-tier system. We didn’t create it.

“Sorry the waiting time for an outpatient appointment is two years, can you afford €200 to pay for a private one or are you happy to wait?”

Waiting list

“Sorry I can only give medication for your mental health problems. Can you afford to pay privately for the talk therapy services you need?”

“Sorry I can’t refer you for a public MRI, I have to refer you to orthopaedics who may sign the form to put you on a further two-year waiting list for MRI. Can you afford €250 to get one privately in two weeks?”

Sorry we can’t manage the fallout from the hospital system any longer. “Sorry I can’t refer you to the HSE dietician to help manage your obesity and diabetes risk. They only see patients with diabetes. Can you wait until you actually develop diabetes?”

“Sorry I can’t do a vitamin D test for you as our local lab won’t do this for GP patients. Yes I am aware most Irish people are deficient, we have been told we should just guess how deficient you may be and guess the correct replacement treatment for you.”

Funding cuts

We are sick of having to apologise for not being allowed to do what we are trained to do . . . “Sorry I don’t have time to remove that skin lesion myself, the funding from the HSE doesn’t come close to covering the cost of disposable equipment and doctor time required. I will refer you to the hospital who should call you within a year. Funding cuts to general practice mean we cannot prioritise loss-making procedures.”

“Sorry I have to keep leaving the room to borrow equipment from other rooms, we can’t afford to have sufficient equipment in every room.”

We are sick of apologising to staff . . . “Sorry that you can’t have paid maternity leave, sick leave and pensions like your colleagues in the HSE have. The Government don’t resource this in general practice the way they do for themselves and the HSE.”

We are sick of apologising to friends and family. . . “Sorry I won’t be home before my son gets to bed. I’m so behind on referrals and paperwork and haven’t even had time to write up some of the notes from today yet.”

“Sorry I can’t go to that meeting, I’m on call that night. Again.”

The aim of this protest is to highlight that GPs are “Sick of saying sorry” and that a complete reversal of Fempi cuts without preconditions, followed by a new appropriate GP contract, is now the only option that will be accepted by general practice.

The system urgently needs to be stabilised before anyone starts to talk about giving us new work. There simply aren’t enough of us to do the current workload, in the community or hospital.

We are all united in saying this . . . Simon Harris, please listen and sort it out before we fall deeper into crisis.

Sinead Murphy is a GP based in Galway