The incoming president of the Irish Medical Organisation (IMO) has warned that a general practice manpower crisis is threatening patient care.
Dr James Reilly, who will assume office at the annual general meeting of the IMO in Killarney later this week, said there were up to 30 vacant medical card lists in the Republic. These are lists of medical card holders entitled to free medical care. "The GP manpower issue is especially acute in urban deprived areas, where the high cost of providing premises means there is a disincentive for GPs to work in these areas," he said.
In the Northern Area Board of the Eastern Regional Health Authority, which has a disproportionate number of areas with a high index of deprivation, there is one GP per 2,500 people. "This is well in excess of the national figure of one GP per 1,600 of the population and double the UK average of one per 1,200 people," Dr Reilly said.
"There is a major issue for Government, which must meet the cost of providing services to people living in deprived areas. The Minister for Finance should create capital incentives for GPs to invest in their own practices. If he can do it for private clinics, private nursing homes and the bloodstock industry, he can do it for primary care."
This would have the added advantage of encouraging GPs to join together to provide better quality services, he said.
This would create the critical mass needed to implement the sort of teamwork outlined in the Government's Primary Care strategy, he added.
Pointing to the difficulties experienced by a specially funded pilot project in Ballymun - where doctors and public health nurses are forced to work from a building that has been closed on several occasions for health and safety reasons while a state-of-the-art primary care centre lies vacant across the road - he said "the Primary Care strategy appears to be going nowhere at present".
"My greatest criticism of the Hanly prospectus and Brennan reports is that they failed to address manpower issues in general practice despite the fact that problems in this area impact greatly on secondary care. Is it any coincidence that we are seeing some of the longest accident and emergency waiting times in the Mater and Beaumont hospitals which serve the health board with the lowest number of GPs per head of population?"
Dr Reilly expressed concern for the future of isolated rural general practice. "Out-of-hours working is the biggest disincentive for doctors in these practices. It is totally unreasonable to expect them to do it for a professional lifetime. This is the rock that rural practice will perish on," he said.