Doctor warns on closure of rural GP practices

People will have to travel further and wait longer for an appointment with a GP in rural areas, as more practices are abandoned, a doctors’ group has warned.

This month there were 24 unfilled practices around the country and research suggests Ireland could lose up to a third of its GPs by 2020.

National Association of General Practitioners president Conor McGee, who is based in Scariff, Co Clare, said GP waiting lists were unheard of three or four years ago.

“In many areas you have to wait two days for an appointment,” said Dr McGee. “The situation is particularly hard for elderly patients who rely on neighbours for a lift to see their GP.

“In Britain, it is one to two weeks and, in some cases, more than two weeks. I really would not like to see that model of care here.”

He admitted, however, the NAGP’s campaign to highlight how successive government cutbacks have impacted on general practice was not getting a lot of support from the public.

Dr McGee said that while people generally trusted and held their GP in high esteem, collectively, they were still regarded as being terribly well off and having vested interests. He also believed the Government was unconvinced when doctors argued their practices would suffer because of cutbacks.

Over the last five years, money paid by the State for medical card patients has been reduced by 40%. There has also been a drop in income from private patients because of the recession.

“The viability of rural practices is under massive attack,” said Dr McGee.

The practice in Scariff, where Dr McGee is one of two GPs, has 3,500 patients. Additional patients have been absorbed from Feakle after a GP left the village and no doctor could be found to take on that practice.

“Yes, the practice is making money, but it is not enough so I can project it will still be viable in the years to come,” said Dr McGee. “A big problem is the workload is increasing and what it pays out is decreasing.

“We really are in survival mode and there is a limit to what we can physically endure before giving in to the stress and duress of it.

“At the moment, less than 3% of the health budget is spent on general practice — it is 9% in Britain and 10% in mainland Europe.

“There is a manpower crisis looming in general practice. There are 2,900 GPs in Ireland and 900 are thinking of getting out within five years. Some of the GPs who are leaving will be retirees, but way too many of them are doctors who don’t see a future for themselves.”

The survey, commissioned by the NAGP and Newstalk, found 47% of GP practices are in debt.

One GP commented that the public income for the group practice was €250,000 last year, compared to €340,000 in 2009. He said the practice had an overdraft of €49,000 because of “steady cuts” by the Government.

Another wrote: “I have become disillusioned about general practice. I am in debt and the practice is running at a loss of €25,000 for the past three years. I am 43 years old. My plan is to wind down my practice and to leave the country as soon as my family can do so.”

One GP did not mince words: “General practice in Ireland is stuffed. It loses money and is subsidised by private patients who have already paid in taxes for all the medical card patients where I work. One patient has had 68 consultations in the past year and cost the practice more than €3,000.”