Action urgently needed to address crisis in GP care, says representative body

Many young doctors are unable to afford to buy their own home and cannot even consider developing their own general practice, the former president of the Irish College of General Practitioners (ICGP) has said. Professor Tom O’Dowd, a GP in Tallaght, Dublin, said there are insufficient numbers of graduates coming from Irish medical schools to “fulfill the future needs of general practice”.

The group held its autumn conference in Dún Laoghaire, Co Dublin, on Saturday, where GPs gathered for a day of discussion and clinical learning.

The extension of free GP cards in the latest Budget could lead to 640,000 more GP consultations, research from the ICGP has found. The ICGP has proposed 10 potential solutions to the growing shortage of GPs in a discussion paper, Shaping the Future of General Practice.

Prof O’Dowd, who chaired the ICGP group which produced the paper, told the conference that the issue of general practice premises was “very important”.

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“Many young doctors are not able to afford their own home, never mind having a mortgage on developing a practice premises,” he said.

“I think that’s quite important, that the State somehow either commissions the private sector or commissions whoever it is to develop premises for multi-disciplinary teams.

“This requires a lot of financial engineering, a lot of imagination and we don’t have much time because otherwise we are in the middle of a crisis and there has to be a response to it.”

Prof O’Dowd said general practice is “by and large in the corner” of Irish medical schools’ curriculum and that it should actually represent about 25 per cent of the entire curriculum.

Dr John Farrell, chairman of the ICGP board, said GP practices are “busier than ever”, but less able to find replacements for retiring GPs, or new GPs to expand their practices and deal with growing workloads.

“The ICGP is now training 70 per cent more GPs per year than it did six years ago, but we have an ageing workforce and an expanding population,” he said.

“Twenty five per cent of our GPs are over 60 years of age. More and more patients are unable to register with a GP practice, because many practice lists are at full capacity, and already there are significant waiting times for routine appointments.”

Mr Farrell said there are currently 30 communities without a full-time GP and that services were being provided by locums and the HSE.

“People are having to wait for routine care. All GP practices would see anyone in an emergency situation, that’s still not an issue but the same day service which we used to treasure is gone for a lot of practices,” he added.

Fintan Foy, chief executive of the ICGP, said the Government’s recently announced budgetary measure to extend free GP care to more than 400,000 additional patients was “impossible” with the current workforce.

The ICGP has proposed expanding GP-led multidisciplinary teams, at least doubling the number of GP practice nurses, increasing remote consulting and introducing a career pipeline for rural general practice.

Increasing exposure to general practice in medical schools and investing in GP data-informatics to drive policy and practice are also among the proposed solutions in its discussion paper.