Out-of-hours GP service, SouthDoc, may be forced to cut the number of its treatment centres because of funding pressures and doctor shortages.
The Irish Examiner understands SouthDoc is looking at a range of options, including reducing the number of treatment centres and amalgamating services. There are currently 23 centres or “cells” across Cork and Kerry.
SouthDoc provides family doctor services for urgent medical needs. It operates outside of normal hours in the Cork and Kerry region. It also provides a call-out service to those unable to travel. Last year, 220,000 contacts were made with the service.
A meeting with the HSE and South Doc is due to take place shortly to discuss options.
Gerard Murphy, a Fine Gael member of Cork County Council who represents the Kanturk/Mallow area, said he has concerns about the future of the Kanturk centre.
“My point is that the Kanturk cell is a totally rural cell with an ageing population and little or no public transport service. Losing the GP would be as bad as closing down the garda station or the post office, it will isolate people completely,” he said.
It is understood SouthDoc is seeking an additional €600,000 a year to maintain its level of service. The co-op receives in the region of €7m annually from the HSE, down from c€11m a decade ago. HSE funding covers the cost of ICT, infrastructure, cars, drivers, nurses, call takers and receptionists.
The GPs cover the cost of hiring the additional “Red Eye” doctors required to ensure a 24-hour service.
The “Red Eye” doctors work unsocial hours — late evenings, nights, weekends, etc and bank holidays — and are typically GPs who travel here from countries such as Australia and South Africa.
However the ability to hire non-EEA (European Economic Area) doctors is being hampered by the current work permit scheme, according to Gary Stack, SouthDoc Medical Director.
Dr Stack said at least five Red-Eye GPs are required to run the Southdoc centres in Kerry, but they had experienced shortfalls recently. He said eight GPs are required to run the Cork centres, but they had also been hit by shortages.
Dr Stack said on the Dingle Peninsula, the existing GPs in the area currently have to cover their own “Red Eye” which means working overnight at the centre in addition to running their own daily practice, “which in the interests of health and safety cannot be maintained”.
“Last weekend [July 27], we didn’t have a GP based in Killarney on Saturday night” he said.
The next nearest out-of-hours GP service is Kenmare or Tralee — a situation he described as “not ideal” at the height of the tourist season.
The current work permit scheme, operated by the Irish Naturalisation and Immigration Service (INIS) within the Department of Justice, allows overseas GPs who are registered with the Medical Council to enter the country for 90 days.
Exit from and re-entry into the State is largely not permitted during this 90-day period.
Once the 90 days have expired, the GP cannot apply for a new permit — known as an Atypical Working Scheme (AWS) permit — until after a 30 day “cooling off” period.
Dr Stack said this essentially meant a GP could not re-enter the state for up to 60 days after they had completed their first AWS permit, as it takes up to 30 days to process the visa.
“This is not conducive to primary care and is causing out of hours significant hardship,” Dr Stack said.
A spokesperson for the Department of Justice said the INIS has, in recent months “consulted closely with the HSE to determine if the terms of the scheme require any amendments”.
“The HSE have advised that they do not consider that any amendments to the current terms of the scheme are required at this time,” the spokesperson said.
The HSE was asked to detail the funding it has given to South Doc over the past five years, but the information was not available.