Dáil Éireann Debate, Thursday - 29 February 2024
15. Deputy Brendan Smith asked the Minister for Health if he will outline the measures being implemented to increase the number of GPs practising in rural Ireland; and if he will make a statement on the matter. [9717/24]
Amharc ar fhreagra17. Deputy Ruairí Ó Murchú asked the Minister for Health his plans to deal with the shortage of GPs in the State; and if he will make a statement on the matter. [9369/24]
Amharc ar fhreagra20. Deputy Brendan Smith asked the Minister for Health the measures being implemented to recruit and retain more GPs in rural practices; and if he will make a statement on the matter. [9716/24]
Amharc ar fhreagraI welcome the measures the Minister has been introducing to strengthen the recruitment and retention of GPs. As he knows, there are particular challenges in rural practices. Recently, I have been engaging with him very strongly and continuously regarding the need for a permanent GP appointment for Swanlinbar, County Cavan. The permanent GP there retired some time ago and a locum has been in place in the meantime. As the Minister will be aware, having heard from me and other local public representatives, the local community is demanding very strongly that the HSE advertise for the post of a permanent GP. I am aware that he has engaged with the HSE on our behalf, which I very much appreciate, but I appeal to him to send on my very strong message. Over the years, the people of the very wide rural Border area of west Cavan have been served by permanent medical practices in Ballyconnell, Blacklion and Swanlinbar. That configuration needs to remain.
There will be an opportunity for only one minute each. We are going to run out of time. I call the Minister.
The question was on general rural GPs but I had a sneaky suspicion we would end up talking about Swanlinbar. I acknowledge the engagement and advocacy of Deputy Smith, other Deputies and Senators on this. The matter has been much ventilated.
As the Deputy will be aware, the GP who provided the service has retired. I believe it was in 2020. The HSE advertised to fill the position on five separate occasions but, unfortunately, it received no application in each case. It then initiated a new measure, under the GP agreement from last year, to work with a larger GP practice in a neighbouring vicinity to supply the services, with a view to having a GP on site in Swanlinbar for several days per week, which is very important, and to providing the wider services, such as nurse-led services, that are available in a larger practice. No final decisions have been made. I have engaged with the HSE on this at length. Ultimately, I want to ensure the people in the area have the best possible access, not just to traditional GP care but also to the growing number of additional services GPs now provide.
On the Deputy’s wider point, we are investing very heavily in growing our GP numbers, particularly in parts of rural Ireland and inner-city areas where it is difficult to get a GP. I am very happy to report that, thanks to a very significant increase in the number of training posts for GPs, we now have approximately two GPs entering practice for every one retiring. In addition, I am working with the Irish College of General Practitioners to bring several hundred more GPs on board. In fairness to the college, it is doing-----
I am really sorry but I have to cut across the Minister to call Deputy Smith.
I thank the Minister. I understand there will be applicants for the permanent GP vacancy in Swanlinbar if the position is readvertised. I sincerely hope it can be. The HSE makes the clinical decision on a suitable applicant. I sincerely hope this can be made in the best interest of the local community. Over the years, the permanent GP service in the area served the community very well. That is what the people of the area want to see continued. I strongly endorse their request in this respect. I thank the Minister for his help to date. I sincerely hope he can reinforce the message to the HSE today again.
I welcome the news in relation to the training of GPs but we need to accept that the GP system has changed somewhat. GP practices were generally private. When we were children growing up, GPs were probably available to people 24-7. They ran their own business, did their own administration and knew everything that was wrong with people and all their family members and everyone else. We are in a different world now.
A number of GPs cannot retire at this point because they cannot find replacements. People are not willing to step in and do not want to run a business or do the administration work. Some of them do not want to work full weeks given their family circumstances. That needs to be addressed and the State will need to step in because the private practice model in place since before the State was established will not work from now in. We need to ensure not only that training is provided but that we have a practice system that will work.
I agree that the State needs to step in and I suggest it has done so in a significant way. We have increased the number of training places from 120 to 350 and we are supporting the ICGP in what it is doing.
I am open to having directly employed GPs. In fact, in Swanlinbar, which has been referenced, there is a locum GP who is paid by the HSE to provide those services. In areas that are struggling to find GPs, I am open to having directly employed GPs.
With the significant increase in the numbers of GPs we are now beginning to see, many of these pressures are beginning to ease and will ease further, although not everywhere all at once. Some areas are under real pressure.
Ireland currently has approximately 65 GPs per 100,000 people. In Scotland, the figure is more than 90 per 100,000 people. Our aim is to get to that level. At the current rate of increasing GPs, we are on track to reach that target in the next five years. It will take time but hopefully people in more parts of the country are seeing better access.
