ICGP has more to celebrate than its 25 years

MEDICAL MATTERS:As the Irish College of General Practitioners (ICGP) celebrates its 25th birthday, its achievements for both Irish doctors and Irish patients have been outstanding

WHEN I started working in general practice we had no mobile phones, and answering machines were large contraptions with poor voice reproduction.

On one of my first nights on call as a trainee GP I remember being called to the southern perimeters of the practice to see a woman in her late 80s.

She was terminally ill and had taken a significant turn for the worse in the early hours of the morning. I sat with her and the family until she passed away some two hours later.

Arriving back to the house, I discovered another call had come in about 90 minutes previously. So off I went again, this time about 20 miles in the opposite direction. A young couple had phoned in with concerns about their child’s temperature, which was not responding to paracetamol and sponging.

When I arrived at about 6am, the lights were out with curtains drawn on all the windows. Eventually, a tousled head appeared in an upstairs window. Dad called down to say the child was now fine; my wife’s advice to place the infant in a tepid bath had worked a dream.

Such was the life of a country GP in the 1980s. It is a reminder of the key role played by the spouses of GPs in those days, long before we had co- operatives for out-of-hours calls and instant communication via mobile phones. But it’s not just the recession that has me reminiscing about the 1980s.

Last Saturday, the Irish College of General Practitioners (ICGP) celebrated its 25th birthday. Its achievements for both Irish doctors and Irish patients have been outstanding, as a perusal of The Irish Timesarchive illustrates. Then medical correspondent Dr David Nowlan reported on its first annual general meeting from Kilkenny on May 4th, 1985.

Significantly, his report centred on contributions from the executive of the GP Wives Association, who were concerned about the lack of sick leave for family doctors. With 75 per cent of GPs working in single-handed practice, serious illness was also a threat to continuity of care for patients.

A year later, the minister for health, Barry Desmond, told the ICGP annual meeting that family doctors would be recognised as specialists under the Medical Practitioners Act. Desmond also promised funding for the college’s research proposals aimed at improving standards in general practice here.

Meanwhile, in May of 1988, there was a report from the annual meeting at which minister for health, Dr Rory

O’Hanlon, warned: “The volume and cost of drugs being prescribed under the GMS and the community drug scheme would have to be curtailed.”

At £60 million per annum, costs had risen by 7 per cent, the report noted. Plus ça change, plus c'est la même chose.

One of the biggest cuts we are likely to see in next month’s Budget will be aimed at curtailing costs in the community drug schemes.

“GPs call for reform of pay system” was a headline from a report of June 1988, marking the publication of the college’s seminal “blue book”. Basically a blueprint for the reform of the health system, it was aimed at giving GPs an incentive to spend more time on health education and patient counselling. Well researched and well written, the book has influenced many of the improvements seen by patients in the past 20 years.

A waft of Thatcherism across the Irish Sea can be detected in the ICGP’s firm rejection of a 1990 proposal from the National Economic and Social Council (NESC). It wanted GPs to set up group practices which would purchase hospital services for their patients.

Undoubtedly, one of the highlights of the past 25 years was the hosting of the World Conference of Family Doctors (Wonca) by the ICGP in June 1998. With 4,000 doctors attending, it gave a £10 million boost to the economy. The occasion also saw the election of the ICGP’s first chairman, Dr Michael Boland, as president elect of Wonca.

A large chunk of credit for the fact that general practice is one of the few well-functioning parts of the health service must go to the ICGP. Take a birthday bow!

• mhouston@irishtimes.com