GENERAL PRACTITIONERS:FAMILY DOCTORS are to resist any moves to have their practices inspected and regulated by the Health Information and Quality Authority (Hiqa), stressing their profession is already sufficiently regulated by the Medical Council and other bodies.
General practitioners attending the annual conference of the Irish Medical Organisation in Killarney at the weekend were critical of the stress and upset Hiqa inspectors caused staff when inspecting some nursing homes, and of the amount of additional paperwork family doctors have had to deal with since Hiqa began inspecting homes.
Tralee GP Bernard Ruane said he was not sure whether family doctors should continue working with nursing homes, because of the amount of aggravation Hiqa’s involvement has caused. “I find it almost impossible to comply with the rules,” he said.
He said he recently found staff in a nursing home in tears following a Hiqa visit. Hiqa had told them they practically had to have cocktail parties every week, he said. In another nursing home Hiqa had caused “ructions” because menus were not displayed on the walls, even though most residents in the home were unable to read or had dementia, he said.
There was laughter from his colleagues when he made the comments. Dr Ruane replied: “You can laugh but these stories are true.”
Mayo GP Ken Egan said Hiqa was “frightening the life out of nurses in nursing homes . . . I was shocked to find experienced nurses seriously upset after a visit by Hiqa”.
“Somebody is going to have to sit down and decide about the bureaucracy and the way it takes so long . . . When you go into a nursing home now to do a call, you have to fill out three or four forms; it’s not [sufficient to] just make a note on the file,” he said.
Kerry GP Eamonn Shanahan, a former chairman of the Irish College of General Practitioners, said he was sure Dr Ruane wanted residents in nursing homes to have access to the highest possible care.
Laois GP Larry Fulham later said there was anxiety about Hiqa moving into the area of regulating general practice. If a promised mandatory licensing system for all health services in the State, both public and private, is introduced, it would be expected Hiqa would then also begin inspecting GPs’ surgeries.
Last December, following the controversy about unopened referral letters at Tallaght hospital in Dublin, Hiqa published a report that found there were huge and unsatisfactory variations in the ways patients are referred to hospitals by GPs.
It has issued draft guidelines in an attempt to address this.
Dr Fulham said the planning laws were already in place to deal with the standard of accommodation in general practice, the Medical Council was there to regulate the profession and it was introducing a scheme to ensure all doctors kept their education and skills updated. “We would prefer not to have another layer of bureaucracy,” he said.
The meeting passed a motion saying it believed Hiqa had no role to play in the regulation of general practice as the area was already sufficiently regulated. They also agreed over-regulation of medical practice will undermine the doctor-patient relationship.