Holly Cairns
Ceist:6. Deputy Holly Cairns asked the Minister for Health the steps he is taking to recruit more staff for the out-of-hours GP cover, SouthDoc, in counties Cork and Kerry. [18353/23]
Amharc ar fhreagraThursday, 20 April 2023
Ceisteanna (6)
Freagraí ó Béal (6 píosaí cainte)
The Minister will be aware of the major pressures GP out-of-hours services face across the country. SouthDoc, which is the Cork and Kerry service, is having issues with recruiting staff, especially in rural areas. That has resulted in some of the services not running. Local GPs and their staff are already overstretched and they cannot be expected to also provide out-of-hours cover. What is the Minister doing to address this issue?
GPs are contracted under the GMS scheme to make arrangements for their patients to be able to make contact outside of normal practice hours. Commonly, GPs are working with co-operatives to do this. SouthDoc provides an excellent and important service to people in counties Kerry and Cork. I acknowledge the commitment of the nurses, doctors and other staff providing urgent out-of-hours care in Cork and Kerry, as well as those who are working with GP out-of-hours services throughout the country.
Nevertheless, I recognise what is implicit in the Deputy's question, namely, that coverage is not perfect and there are concerns. I know, for example, that around Castletownbere there are difficulties in recruiting locum doctors. Sometimes that means that patients have to travel further than is ideal for the use of SouthDoc services. I am also aware of concerns about provision in Fermoy, although I am assured that there are no plans to change the service there. I think there are some local concerns that there will be a diminution of the service.
SouthDoc is a private entity which has more than 500 GPs, 26 treatment centres and 19 vehicles. To address the Deputy's question, as a private entity, it is up to SouthDoc to hire as many GPs as it can. There is, however, more we can do. At the IMO conference in Killarney, some doctors involved in out-of-hours services asked me to convene a national forum on out-of-hours services so they can come together to share what is and is not working. We are now kicking off the strategic review and out-of-hours services will be part of that. Some parts of the country are receiving an excellent service. In some parts of the country, services are finding it difficult to recruit. In some parts of the country, to be honest, the services are probably run in a more productive manner than in others. We want to ensure we have consistently good coverage across the country.
I acknowledge the Minister's statement about the forum, which is great, but I wonder when it will happen. I am not feeling a sense of urgency from the Minister in relation to this matter. There needs to be a greater priority given to recruiting and retaining doctors in these services, especially in rural areas like west Cork. As the Minister said, I previously raised with him the case of the Castletownbere service, which has been completely unavailable on multiple occasions due to staff shortages. The regular GP staff are doing all they can.
In reply to a parliamentary question, the HSE told me that due to the reliance on locum doctors and the significant shortfall in their availability, there may be occasions when this additional support is not available. For people in Castletownbere, the nearest SouthDoc service is almost an hour away, either in Bantry or Kenmare, on quite bad, narrow country roads. The Minister can imagine how difficult it would be for someone with a sick child or an elderly parent.
Another case is the Kinsale service, which was closed a number of years ago, despite huge local opposition. Kinsale is a large and growing town which should have a dedicated service.
I fully acknowledge that, particularly around Castletownbere and other areas, it is a great worry for parents or anybody else that getting to a GP could involve a long and difficult drive at night. That is not something we want to see. There are several things we are doing which will take time but will make a big difference. For example, we are trebling the number of GPs in training. That will take time to deliver the number of GPs we need but it will result in a substantial increase in GP numbers.
What can we do in the meantime, over the next one to four years? We are working with the Irish College of General Practitioners on international recruitment. For example, it has a project to bring in GPs from South Africa and other countries and it is targeting, in particular, rural areas such as Castletownbere and many other areas in Deputy Cairns's constituency. We can do more, including bringing together a forum and seeing what else can be done through the upcoming strategic review.
This matter needs to be more of a priority because this service provides vital care and is needed by people not just in west Cork but in other rural areas. I understand these things can take time but there is also a lack of joined-up thinking and utilisation of resources, which can be frustrating for people in those areas.
SouthDoc services are under pressure and, at the same time, Bantry General Hospital's medical assessment unit only opens from 9 a.m. to 4.30 p.m. Extending the opening hours of this unit is not only important in itself but would help relieve the stress on SouthDoc services. The absence of those services, in turn, adds strain to the few ambulances operating in west Cork. Between Bantry, Skibbereen and Castletownbere, three ambulances are ordinarily operational but they might go somewhere else and then travel elsewhere from there. One rapid response unit operates between 7 a.m. and 7 p.m., after which it no longer operates. Each of those systems is under-resourced, which puts additional strain on all the healthcare workers in the area. We need to take a more holistic approach to this. SouthDoc needs more staff, Bantry General Hospital's medical assessment injury unit needs to be open for longer and we desperately need more ambulances.
I am very happy to look at the situation in Bantry General Hospital. We are expanding access to the medical assessment units as part of an expansion in urgent care. If there is a shortage of fleet in the Deputy's area, I will talk to the National Ambulance Service about that. We have invested a significant amount of money in the service this year and last year. It is expanding and modernising its fleet and hiring and training many more paramedics and advanced paramedics. The ambulance service is not there yet but it is rapidly moving in the right direction. I will raise the concerns with the National Ambulance Service.
Significant investments are being made in Cork University Hospital, Kerry University Hospital and the Mercy University Hospital. This will also help a great deal in the Deputy's constituency. While these hospitals are not located in rural areas, increased capacity in them will make a difference at a regional level in terms of the more localised services the Deputy referenced. I will certainly raise with the HSE the issues the Deputy has outlined.