Madam, - I would like the opportunity to comment on your recent Editorial on "the GP gender issue" (July 8th). The Irish College of General Practitioners (ICGP) has statutory responsibility for general practice training in Ireland. The college has campaigned over many years for an increase in GP training places as nobody is more aware of the impending GP manpower crisis.
However, a sole focus on the so-called gender issue is not helpful in addressing this issue.
Continuity of care and management of chronic disease are vital components of general practice for both patient and doctor. Continuity of care can be safeguarded by careful planning of review appointments and is not incompatible with part-time general practice. What is incompatible with part-time work is being able to contact your own GP in an emergency situation and unless every doctor is to work round the clock every day of the year this cannot be guaranteed. A substantial number of general practitioners, both male and female, are working less than "full time" and are successfully delivering a first-class, modern general practitioner service to their patients in an organised manner with the back-up of appropriate out-of-hours service.
The TCD report, yet to be published, and on which your Editorial is based, looked at recent graduates from GP training, 94 per cent of whom are currently working in general practice in Ireland. The majority, both male and female, are at an age where raising a family may be a priority. It is not possible, at this juncture, to determine their future level of commitment, a resumption of full-time work.
While the report clearly indicates that far more female than male GPs are working part-time, it is wrong to assume that all young male graduates are working full-time. The report will show that 33 per cent of males are not in full-time clinical practice. Therefore it is much more helpful to deal with the reality and ask why are young GPs not working in full-time positions?
The ICGP would suggest that current structures, working and contractual arrangements (both private and public) are largely responsible for this situation. The current GMS contract specifies that the GP is responsible for providing care 24/7 for 365 days of the year. The opportunity for part-time work or job-sharing does not exist. Surely young doctors should be provided with these options, which are considered standard working practice in most modern workplaces?
It is time to move the debate forward. Let us concentrate on trying to prevent a crisis in general practice manpower by constructive suggestions rather than focusing on the so called "gender issue". - Yours, etc,
Dr MARK WALSH,
Chairman, Irish College of General Practitioners,
Lincoln Place,
Dublin 2.