GPs urged to embrace changes to primary care

GPs have been told to embrace change and to remember that health managers can’t introduce reform without the support of doctors around the country.

The message was delivered at a conference of the Irish College of General Practitioners by the medical director of St Patrick’s Mental Health Services, Professor Jim Lucey, who said GPs should make themselves an integral part of the development of primary care services.

“Don’t be afraid to change,” Prof Lucey told the conference in Clonmel at the weekend, adding that the HSE and Department of Health need GPs to make changes to the system. “Many in the profession recognise that change is inevitable. Very few in the profession see change as opportune. Change is particularly difficult for those invested in primary care who are heavy burdened with mortgage debt and dependence on private practice and specific government payments. Since the collapse, the private patient is often unemployed or at least lower paid or even migrated, and so no longer has the spare euro for private GP services. Likewise, specific payments from the state for GP services are all reduced.”

Prof Lucey concluded: “The people you’re in a scrap with know they cannot deliver either the service or the reform of the service without you.”

Earlier, there were some angry words for the Minister of State with responsibility for primary care Alex White as he spoke about the new draft contract for delivery of free GP care for children under-six. Some GPs heckled the minister about their unhappiness with the draft contract, but he said: “It’s not just about me handing you a contract and saying, ‘sign it, take it or leave it’. That is not my intention.”

The contract is not a “fait accompli,” Mr White said, adding that he looks forward to discussions with doctors’ representative bodies.

The minister accepted that resources have been cut from the health services.

“I accept that primary care is under-resourced and I accept, as anyone with a brain can see, that in a country where you’ve had the kind of economic collapse that we’ve had, the impact that it’s had on social services,” he said.

“You cannot take €3 billion out of the health service and say it’s not going to have an impact, it’s clearly had a serious impact and it’s visible to me right across the country and it’s visible to me and manifest to me that that has to be addressed. But we can only do this in a process with dialogue.”

The ICGP has described the draft contract for GPs, relating to free care for under-6s, as “not deliverable with current available manpower”. The college’s medical director Dr Margaret O’Riordan said the contract is a forerunner for the whole population. “It’s all-encompassing, it’s vague, it’s bureaucratic. It’s layers and layers of things that will have to be reported on. If you’re going to have your GP spending time reporting and doing paperwork then they’re not delivering the services they were trained to deliver,” Dr O’Riordan said after her conference speech.

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