What happened to house calls?

 

Sir, – Further to Verrell Booth’s question (January 15th), house calls by GPs in Ireland and UK continue to be an important service to the truly sick, such as the terminally ill and nursing home residents, but have been in decline for more than 30 years.

This reflects a higher standard of care that is available in-surgery with access to equipment, paramedical staff and the complete patient record. Improved personal transport and communications such as the smartphone have also made visiting the family GP so much easier.

Disproportionate government cuts of 38 per cent to general practice funding in recent years and the removal of distance codes have made home visiting financially non-viable and have accelerated this decline.

With 660 GPs who are over 60 years of age (30 per cent of all GPs), coupled with the exodus of younger GPs abroad, it is likely that your letter-writer will soon be asking the question, “Why does it take my GP four weeks to see me in-surgery?” – Yours, etc,

Dr WILLIAM LYNCH,

Whitemill Medical Centre,

Clonard,

Co Wexford.

A chara, – While it is no doubt a source of disappointment to many that such a personalised physician service is no longer available, one is struck by your letter-writer’s pondering as to what has gone “wrong”. The simple facts are that since the days of regular housecalls, the practice of medicine has in fact vastly improved! Communicable diseases and vaccine preventable illnesses have fallen, infant mortality is lower than ever and we are living longer and healthier lives than ever before.

It is of course appropriate to question where things have gone “wrong” and, perhaps in a roundabout way, your letter-writer is correct in lamenting the reduced availability of general practitioners. Consistent and convincing evidence has shown that appropriate funding and provision of primary healthcare results in better outcomes for the community. Slashing general practice funding by 38 per cent with financial emergency measures in the public interest (Fempi) cuts was and continues to be a misguided policy.

While the days of treatment of all illness in the home are long gone and never to return, with vision, funding and commitment, the Minister for Health has an opportunity to harness the abilities of general practitioners to improve healthcare for many years to come. It is in the best interests of all that Simon Harris uses evidence-based policy and funding to reverse Fempi cuts and restore general practice funding. – Is mise,

DAVID DORAN, MICGP

Clontarf,

Dublin 3.