Lack of counselling 'forces GPs to prescribe drugs'

FAMILY doctors have said they have no choice but to medicate people suffering from depression given the complete lack of counselling services, particularly for medical card holders.

The Irish College of General Practitioners (ICGP) said the Government had spent only €20 million on primary care in the last two years. Under its Primary Care Strategy, the Government proposed to roll out over 10 years a network of primary care centres, encompassing GPs and counsellors, under a €1.27 billion plan.

"The amount of investment by this government and previous governments has been minimal. There just aren't the resources there," said Dr Eamonn Shanahan, chair of the ICGP.

He said medical card holders with depression had no access to alternatives to medication, such as counselling.

"The group I would argue that are at greatest risk the unemployed, under-employed, elderly, medical card patients have not got access to alternatives for drug treatment.

"There is a scandal there. If you have the wherewithal, you can afford counselling. If you are a medical card patient you don't have access to counselling and there are relatively few, if any, alternatives."

He said counselling was very effective, but was also time-consuming and therefore expensive to deliver.

"For many GPs, other than prescriptions, there are very few options. That said, it is important GPs would take on board the totality of the person's picture."

Dr Shanahan's comments follow a Prime Time report earlier this week questioning the rapid rise in prescription levels of anti-depressants and the close relationship between doctors and drug companies.

The report said the number of prescriptions had doubled between 1993 and 2002 to 1.5 million and that 300,000 people were taking anti-depressants in 2002.

This included 200,000 medical card holders, one-in-six of all card holders. In a survey of GPs, the programme found 60% of family doctors felt their fellow GPs were influenced by drug companies.

Dr Shanahan said it would be "naive" to think doctors would not be influenced by the sponsorship of pharmaceutical companies.

But he said drug companies sponsored reasonable, proper and ethical research.

He added the ICGP had guidelines on sponsorship from drug companies, but there was no sanction against doctors who breach the guidelines, apart from possible action by the Irish Medical Council.

Help at hand

300,000 people suffer from depression.

Around 500 people take their lives every year.

For helplines contact Aware at 1890 303 302 or Samaritans at 1850 60 90 90.