It has been a constant struggle for Dr Brid Walsh to keep her general practice in North Kerry going.
It is a three-doctor practice working between two clinics in Abbeydorney and Ballyheigue.
In 2015 Dr Walsh took over a practice that had been vacated three years previously.
After combining practices with another woman GP Dr Walsh was able to sustain herself while she waited for payments from the Department of Health and the HSE.
“Had we not taken on that list – the entire North Kerry head, it would have been without a GP,” said Dr Walsh, who is a member of the National Association of General Practitioners.
It was at a time when suicide rates among young men were particularly high in the area and locals feared that they had been forgotten.
Dr Walsh said she “cut her cloth” after Government funding for primary care was cut under financial emergency legislation.
I have made cuts in my overheads and expenses. It is tight but more bothersome is that my patients simply cannot get the care they deserve.
Dr Walsh said three-quarters of her patients had a medical or GP visit card.
“I can't explain to them that if they had insurance they can get an MRI and if they haven't they have to wait 11 months to see a urologist who will then sign a form to have it performed.”
Dr Walsh said someday she might want to start a family and at that time of her life would like to rely on the State to organise maternity leave for her.
A colleague who ran a practice single-handed up to a week before her child was born could not find a doctor willing to take over her practice while she was on maternity leave.
The HSE eventually stepped in and appointed a locum doctor but the woman GP was not happy with the arrangement and ended up back in the practice sooner than she intended.
Dr Walsh said her practice now had four doctors, three nurses, four secretaries and a practice manager but the money from the GMS contract did not cover the outgoings of what was a small business.
She had to charge for services, not because she wanted to, but because she had to have money to pay her staff.
Dr Walsh said she came from a non-medical family and was the first to go to college.
“My family was astonished at where the money was going and how much money I had to spend. It was something I was naive about.
“I think there is a willful intent to hide the true cost of free care from the general public and therefore muddy the waters and make it seem as though I am ferociously wealthy when I am truly not.”