Deprivation studyA lack of access to hospital and community services and the psychological needs of patients are significant barriers for GPs providing care in deprived areas, a report by the Irish College of General Practitioners (ICGP) has found.
The report, Health Inequalities and Irish General Practice in Areas of Deprivation, is based on a survey of more than 700 family doctors in the Republic. Some 40 per cent of respondents felt they were practising in areas of deprivation, while 30 per cent of doctors reported that more than two-thirds of their patients had medical cards.
Asked to rank the top three difficulties in providing care to their deprived patients, 60 per cent of GPs said that problems accessing hospital and other services were a significant barrier. Dealing with a high level of social and psychological problems among their patients was a difficulty for more than half the GPs. A lack of time to deliver quality services because of an excessive workload was a factor for about four in 10 doctors.
When asked what practice services they would develop to improve their patients' health if they had more resources, more than half the GPs listed counselling, physiotherapy, multidisciplinary team working and social support for patients as key areas.
The main obstacles faced by patients trying to access hospital services were long waiting lists, the two-tier system of access and bureaucracy, according to the doctors.
Commenting on the findings, the author of the report, Dr Philip Crowley, deputy chief medical officer at the Department of Health, said: "The health inequalities in our society are stark and must be a key priority for action. General practitioners must be active players in programmes to address these inequalities.
"Future investment in primary care must take account of the need to prioritise multidisciplinary team development in areas of deprivation."
In the recent health estimates, Minister for Health Mary Harney announced the recruitment of 300 staff to create an extra 75-100 multidisciplinary primary care teams.
Dr Crowley said that it was well established that the health of those in poorer communities was significantly worse than in wealthier communities.
Evidence for this included a doubling in death rates for people in the lowest occupational class, while deaths from heart attacks and stroke were 120 per cent higher in the lowest occupational grouping, he said. Dr Crowley's report recommends deprivation payments be introduced in general practice across a range of deprivation levels. It also recommends access to general practice and secondary care be monitored for equity "on the basis of social class and ethnicity".