State has sidelined us healthcare reform plans, say GPs

DOCTORS are angry at being sidelined in the State’s plan to reform the healthcare system.

In its first definitive response to three Government reports on healthcare reform, the Irish College of General Practitioners (ICGP) say their role so far has been minimal.

Two years on, there are still only 10 primary care centres in the country, despite a promise that there would be 600 by 2012.

In each of the reports there is a nod to general practice no more than that, said newly elected ICGP chairman, Dr Eamonn Shanahan

"While reference has been made to the fact that general practice and primary care will be very much at the core of those developments, thus far there has been negligible additional investment to move that forward," he said.

The Government's own primary care strategy had allowed for an investment of over €1 billion over the next 10 years, out of which only €16 million had actually been spent, he said.

"That should be put in the context of the National Roads Authority asking for an additional €2 billion so they can get the roads finished two years earlier," he added.

The GP from Farranfore, Co Kerry, said they were particularly opposed to the proposal in the Hanly Report to make healthcare more hospital-centred and specialist driven.

While better outcomes can be achieved by having hospitals with more patients and high volumes of certain procedures, the potential for high quality care could only be realised if demand is properly managed.

Long waiting lists, however, were resulting in unplanned admissions and delays in processing them. It was no longer uncommon for patients to be lying on hospital trolleys for up to four days. And, said the ICGP, the country's largest hospitals with the highest number of consultants were the worst offenders.

The ICGP, which has around 2,600 members, said GPs can reduce patient demand for hospital services if there is more investment in primary care resources, direct access to diagnostics and better patient education.

The current emphasis of the reform programme, however, seemed to exclude general practice and primary care and focus largely on the administrative and management structures, financial management systems and hospital services.

Referring to the Prospectus Report, the ICGP is concerned that while there will be a central body for the development of hospitals, primary, community and continuing services will continue to be developed at regional level, a situation that would result in duplication and chaos.

The ICGP is also disappointed that the Brennan Report did not explicitly address the question of transferring funds from the acute sector to primary care.

It believes there are significant numbers attending hospital outpatients who could be cared for in general practice if appropriate incentives were in place for patients and doctors.