It has been an honour to serve you as President for the last year and I look forward to the challenges of the year ahead. At the outset, I wish to acknowledge the talent, commitment and drive of the National Council. They have made a considerable contribution the strength and dynamism of the organisation. I have to, in particular, acknowledge the dedicated work of our CEO, Chris Goodey, and the support staff in our Dublin and Kilkenny offices.
The core message of the NAGP has never changed and it was what motivated me to get involved in the NAGP in the first instance – General Practice is in crisis – and the NAGP are strong in our assertion that we cannot watch our profession be systemically degraded. Such is the reputation and standard of General Practice in Ireland that our existing, and established, GPs are being head hunted for overseas roles.
The last year has been a blistering pace with bringing the issues General Practice faces to the fore of conversation in public awareness, the media and in political circles. The NAGP has been very active in seeking solutions to the provision of GP-led Primary care through its submission documents to the Joint Oireachtas Committee on Health; to the Oireachtas Committee on the Future of Healthcare; to the GP Out of Hours Review Group; our Pre-Budget Submission 2017 and our vision for the new GP Contract. The NAGP has been an active member within the Primary Care Partnership movement which is the only forum I am aware of that exists across all primary care health and social care professionals and groups. The second meeting of the Partnership was held in Croke Park this year and grew even further on last year’s success. One of the main ‘take home’ messages and action points, of many, in my opinion, was the need to support and grow the role of the Practice Nurse in General Practice. The NAGP are actively seeking increased Practice Nurses in General Practice from a half ratio to GP as it currently stands to a 2:1 ratio. I am very concerned with the proposal to make community nursing the first point of contact, without any relation to General Practice. It is clear that this will be a huge cost and that it will increase the work load on General Practice.
When I took up my post a year ago, I spoke about the importance of public education as to the realities of the crisis in General Practice as well as the need to be solution driven to address this. I feel we have made fair inroads in the last year, however it has become clear to me in the last year that having the political body moving in the same direction is essential. In the last few months, I have spent considerable time in Dail Eireann on this very issue. It is a slow process but essential. In my view, GPs need to step into the political space and advocate for change and their patients there. I frequently hear from colleagues that politics is not for them. We can spend all the time we want in isolation at conferences and meetings confirming how good we are at what we do. However, if we do that in isolation without influencing the political system and bring them along with our thinking, nothing much will change! I am not asking GPs to leave their clinical roles, but I am asking them to engage with their elected representatives.
In the last year, the NAGP sought healthcare reform using the platform, the Tallaght Strategy for Health, calling for a ten-year strategy which was removed from the political cycle. With the formation of the new Government, this ethos was included in the programme for Government. The report from the Future of Healthcare committee is overdue to be published. The committee’s mandate is to put patient care above politics and to map out meaningful reform of the health service. It is my sincerest hope and wish that it delivers on this principle and does not slip into individual agendas or anecdotal reactions in providing for health care. We will examine its findings carefully and interact with our membership for opinions and direction.
It was the NAGP’s stated intention to engage with the HSE/DOH and the political body to be a strong voice in the negotiation of a new GP contract. I am glad to say we have reached that objective. However, we continue to seek immediate investment in General Practice to restore functionality to the service, address the manpower shortage and stem emigration.
I wish to recognise the strength of our membership numbers which made the omission of the NAGP in the negotiation process impossible. The reversal of FEMPI is very much to the fore of our thoughts especially when it is being unwound for civil servants. Prior to the FEMPI cuts, we had a viable GP service. We provided services above and beyond the scope of our GMS contract because that is what we do in the nature of being a General Practitioner. On the back drop of the austere FEMPI cuts, we had to rationalise services that we are providing for free and at the cost of running a practice and employing staff. Such was the impact that practices had to reduce staff hours and take even on more workload. I know this came at a huge cost to GPs in their personal and home lives and has been a cause for ill health and burnout. Those real stories have left a mark on me and drives the NAGP on in our work.
I want to reassure the NAGP Membership while we are actively engaging in the process of shaping a new GP contract, we have not forgotten the ongoing crisis in General Practice which ultimately has an effect on patient care. For the first time, we have witnessed unfilled places on the GP training schemes – an indicator of the perceived viability of the profession. We will continue to lobby and apply pressure for immediate funding into General Practice.
Dr. Emmet Kerin