HSE assigning violent patients to GPs without consultation – conference hears

Violent patients are being assigned to family doctors’ practices by the HSE without consultation or background information being provided, the annual conference of the Irish Medical Organisation (IMO) has been told.

Dublin GP Dr Ray Walley said doctors just received a letter from the HSE telling them such patients had been attached to their practice.

He said GPs were sent no information as to why patients were being assigned or even about the identity of their previous doctor. Some GPs only become aware a patient has been assigned when he or she turns up in their practice.

“You may have a potentially hostile patient or actually have a hostile patient”, Dr Walley said.

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“A lot of these patients have anger issues. They feel they have been deflected all the time. When they come to us , some of them explode because they think we are telling lies and then we are trying to ring the State services.”

Dr Walley said some GPs have been assaulted by patients assigned to their practice.

One GP told the conference of a patient who had to be chaperoned from the time they arrived at the practice to the time they departed.

The conference passed motions calling on the HSE to cease the practice of assigning patients to GPs without their consent, particularly in the case of violent or aggressive patients who may pose a danger to other patients of practice staff.

The conference urged the HSE to establish a separate service for the provision of care for violent or aggressive patients.

Dr Walley said the current system was not safe and that the State was abrogating its responsibilities.

He said such violent or aggressive patients should be cared for in a secure setting with appropriate back-up.

Online consultations

Doctors were also warned of the potential dangers of patients using online and telemedicine services for consultations with GPs they do not know.

Dr Walley said he had a recent experience regarding a patient who had been prescribed anti-depressants on foot of an online consultation.

He said when the patient subsequently presented at his surgery she was “floridly suicidal” and the seriousness of her condition had been missed by the doctor in the telemedicine service.”

“This is a race to the bottom,” he told the conference. “Those who are most vulnerable will suffer.”

Dr Walley said an audit in the UK had found evidence of inappropriate prescribing of antibiotics and opiates arising from online or telemedicine consultations.

GP Dr Pascal O’Dea told the conference that doctors providing the service outside the country did not have to be registered with the Medical Council in Ireland. He said he had “grave concerns” about this.