I thank the Minister of State for taking this important Topical Issue, namely, the need for a dedicated general practitioner, GP, training programme for County Kildare. We have a great GP service, but I am concerned about the amount of pressure on the county's current GPs. It will only worsen as the county's population grows and older GPs move towards retirement.
Someone who wants to become a GP studies medicine for six years, does a one-year internship and spends four years in the training programme for dedicated GPs, which entails two years in a hospital and two in practice.
There is no clearly defined area for Kildare at present. This creates a problem for retention levels. The latest Medical Council workforce intelligence report shows that County Kildare has only 41 GPs per 100,000 population. This is the fifth lowest ratio in the country and is well below the national and international averages, the national average being 51 per 100,000. Up to 25% of Kildare GPs are predicted to retire in the coming decade. This is concerning and, if they are not replaced and even more recruited, it has implications for patients, practices and an already overstretched out-of-hours service.
As the Minister of State will be aware, Kildare has one of the fastest-growing population centres in the country, with an increase of 5.6% according to the 2016 census, the third-largest growth nationally after Fingal and Meath. That percentage represents an extra 11,800 people living in Kildare since 2011. It is estimated that every 2,500 in population growth in the county creates the need for a new GP, which means that almost five new GPs are now needed in addition to our 2011 numbers.
The programme for a partnership Government emphasised the need to focus on enhancing primary health care services, including by building up GP capacity and increasing the number of therapists and other health professionals in primary care. In order to do this while also investing in primary care centres, we must ensure that we can attract and retain more young doctors to work as GPs. Specifically, I want to ensure that Kildare has a sufficient supply. We are lucky to have 20 GP trainers operating in the county. They are spread across a variety of schemes - midlands, midlands-Naas, Royal College of Surgeons in Ireland, RCSI, TCD and UCD. It is this spread that is the crux of the issue. While these programmes get all of the benefits of the Kildare GP community and the KDOC out-of-hours service, Kildare itself does not retain enough graduates to meet future demand.
Internationally, it has been shown that the presence of a local and identifiable GP training programme is an effective way of doing this. County Donegal is a good example. One would imagine that, due to geographics, it would be harder for that area to retain GPs after training than it would be for somewhere like County Kildare, yet Donegal exceeds the national average of GPs per population because it has its own identifiable training scheme.
During recent presentations on the future of health care, Professor Susan Smith stated that one of the solutions to the issue of GP retention was providing targeted GP training in areas where GPs were needed. I would like to see a GP training programme in County Kildare to help retain GPs. The necessary skills and infrastructure are already in place, so this measure should not have a significant additional cost. I understand that a reorganisation of GP training has been proposed for 2018 when the Irish College of General Practitioners, ICGP, will take over from the HSE. This is an opportunity for Kildare to have our own training programme. We would welcome the Minister of State's support in this regard. The programme would have the support of the majority of Kildare GPs and GP trainers and would be of significant benefit to Naas General Hospital, as trainees would spend two years on hospital placement.
I will outline the pressure that our GP services are under. KDOC deals with 60,000 clients per year. This phenomenal figure shows the level of work involved, but we will need to be able to increase our numbers in light of our growing population. The age profile of GPs is heading in the wrong direction.