THERE WILL be very significant shortages of GPs in the State by 2021 – possibly driving up the cost of seeing a doctor – unless training places are increased dramatically, according to a new report from the Economic and Social Research Institute (Esri).
The report published today states that Ireland already has a very low ratio of GPs per 100,000 of the population compared to most western European countries.
It says that if we are even to maintain this low ratio, an extra 350 GPs will have to be in place by 2021 to keep pace with population growth and retirements from the profession. It states that if our GP numbers are to rise to the EU average of 87 GPs per 100,000 of population by 2021, we will need to recruit another 1,800 GPs. At present, just 121 GP training places are offered every year.
“An expansion to 250 GP places would certainly compensate for retirement and population growth and start to make real progress in improving the supply of GPs towards an adjusted EU average,” it says. “A failure to expand GP supply would have knock-on effects which could include price increases, longer waiting lists and an increased burden on emergency departments in hospitals as patients seek alternative modes of care,” it adds.
The report, Projecting the Impact of Demographic Change on the Demand for and Delivery of Healthcare in Ireland, says the population will increase from 4.2 million in 2006 to 5.1 million in 2021, and it predicts demographic change will increase total GP consultations by 33 per cent by 2021.
It points out that some counties are already worse off than others in terms of their GP ratios. Cork, Galway and Waterford appear to be better-supplied, with an estimated average of more than 65 per 100,000 compared to fewer than 45 per 100,000 in Clare, Offaly, Monaghan, Laois, Meath and Kildare. These counties are “chronically short” of GPs for their populations, it says.
“In Monaghan and Kildare, rising populations have been met with declining numbers of GPs over the 2004-2008 period, meaning that each county requires at least 30 more GPs to match the national average GP to population ratio,” it adds. “By 2021, it is projected that Meath will have only 27 GPs per 100,000 population, compared to 63 in Cork.”
Dr Stephen Thomas of the Centre of Health Policy and Management at TCD, who wrote the paper on GP shortages, said the shortages would seriously impact on the ability of the Government to deliver healthcare reform.
“One of the issues for the Government is they want to see an expanded primary care system and less dependence on hospitals. And so, one of the key aspects to be able to meet that is to have sufficient GPs to be able to provide primary care in the community.
“So unless we expand training or find another way to get over this, you are going to be hard-pressed to keep things as they are now, never mind make things better and build up the primary care system the Government is so interested in,” he said.
The report suggests remedies might also include using nurses and pharmacists to do more work now done by GPs, or encouraging GPs to retire later. It also says over 13,000 additional residential long-term care places (a 59 per cent increase) will be required by 2021 if the current uptake rate of residential care by older people with disabilities continues.