Patients to wait ‘weeks’ for doctor visit if free GP care extended, union warns

Patients may have to wait “weeks” to see a family doctor if the Government proceeds with plans to give free GP visit cards to an additional 500,000 people, the Irish Medical Organisation has warned.

More GPs will be forced to close their doors to new patients due to the increased burden the plan will place on doctors, it says.

GP services will be “overwhelmed”, care for those who most need it will be displaced and pressure will increase on out-of-hours GP services and hospital emergency departments, it also predicts.

Minister for Health Stephen Donnelly is provide and update on plans to widen access to free GP care in his address to the IMO conference in Killarney on Saturday.

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In last year’s Budget, the Government announced plans to provide 430,000 GP visit cards to people earning under the median house household income and 6-7 year-olds. However, implementation of the measure is running behind schedule as talks with the IMO have yet to conclude.

At the IMO conference, Dr Tadhg Crowley, chairman of the GP committee, will tell delegates on Saturday that overwhelming general practice will “destroy its potential and could lead to those with serious health conditions being unable to access urgently needed care”.

“It has been clearly demonstrated that extending the numbers eligible for free GP visits leads to increased demands to see GPs. Without significant additional resourcing, GP services will simply be overwhelmed by the increased demand. Appointments may be free but they will be harder to access leading to displacement of care for those who need it most.”

At present, the IMO says, GPs are being forced to close their lists to patients, to defer routing appointments for up to two weeks and to forego holidays because locums cannot be sourced.

On Friday, the conference heard that frustrated patients are increasingly directing their anger at staff in GP surgeries.

The amount of abuse directed at secretaries in particular is rising, according to Cavan GP Dr Rukshan Goonewardena.

Capacity problems in general practice since the Covid pandemic have been “relentless”, he said: “We’re so busy fishing people out of the river instead of finding out why they are falling in.”

The two-tier system of access to healthcare so prevalent in Irish hospitals is about to “contaminate” general practice, Dr Denis McCauley warned.

Poorer families will have to wait to see a GP while better-off patients are treated quickly if demand continues to rise, he said.

GPs have always treated public and private patients in the same way, but growing pressure on the system is leading them to a “significant moral Rubicon,” according to the Donegal GP.

“If demand goes up, the less well-off will have to wait while people who can pay will go private. This will be a terrible indictment of the health service and it won’t be reversible.”

Another GP, Dr Niall MacNamara from Waterford, called for a “Marshall Plan” to tackle the impacts of population growth on health, housing and education. Doctors are close to rationing healthcare as a result of the pressures on the system, he warned.

Doctors are working up to 100 hours a week in emergency department as hospitals struggle with increased demand but static resources, emergency medicine consultant Dr Mick Molloy told the conference.

The 11,800 hospital beds in the system today is 8,000 fewer than 20 years ago, resulting in increased numbers of patients on trolleys, he said.

While plans have been made to create more capacity, they are just “good intentions” unless they are converted into hard work to ensure their implementation.

The capacity crisis in health was “entirely predictable” because not enough extra beds were built, Dr Murphy said, and every single hospital in the State needs a new building programme. The new national children’s hospital will have fewer beds than that three Dublin hospitals its replaces, he pointed out.

Emergency medicine consultant Dr Peadar Gilligan pleaded for more beds to be built. He said he often has to “bagsie” a trolley to see a patient, such is the lack of clinical space in his hospital, by placing clinical notes on it. However, sometimes someone else still takes the trolley and he has to spend 15 minutes looking for a space for clinical care.