The meeting also attracted 11 TDs and Senators who heard first-hand about the crisis taking place in general practice. Dr Ed Walsh, the founding President of the University of Limerick opened proceedings by stating that the problem with the Irish health system was not the lack of money, but the allocation of money.
“We spend more on our system than any country other than the US – adjusting for age. And an OECD study recently ranked Ireland as the least efficient in the world. That is because Bertie (Ahern) refused to allow Mary Harney to reduce the number of managers when the HSE was formed,” he said.
Dr Walsh went on to say that If Irish system was as cost effective as the Australian one, €3 billion could be saved. He said the percentage of consultants in the Irish system was 40% of international norms while the percentage of GPs is 50% of the norm.
He added that the government approach was correct – to improve primary care and put more resources into primary care , but he said ‘perversely’, the extraordinary thing that has happened is that the funding for the GP system has been reduced by 30-40%.
She also noted that under the Universal Health Insurance (UHI) plan the public were being sold the idea of universal access, but in fact, it was something different – a system that would have to be paid for through another means. She also noted that under such a system, insurance companies would have to take a profit thereby increasing costs.
Dr John Casey, who runs a practice in Clifden, spoke about the effect the FEMPI cuts had had on his patients and on his practice. The practice is a relatively big one, providing a range of services with four GPs and a nurse, but it had been ’emasculated’ in the last few years. He pointed out that in the Clifden area, some of the home visits can be up to 50 kilometres.
“We have four rounds of cuts which have had a savage effect – a 40% cut in resources to provide services. The cuts were applied to total practice income not salary,” he said.
He said that the GPs in his practice were working up to 70 hours a week and that a lot of their essential diagnostic equipment is not being replaced.
“I’ve been 40 years in general practice. The FEMPI cuts have been the worst thing that has happened in that time. In the UK and Belgium the Competition Act was set aside to allow docs to negotiate with the government and the same thing should happen here,” he said.Dr Seamus O’Beirne told the meeting that in Ireland less than 3% of €13 billion health budget was provided to run a 365-day-a-year service.
He noted that the Primary Care Strategy was ‘simply 13 years of failure’.
“You have to get personal responsibility in the HSE – like GPs have. I have a feeling that there’s a lot of people in the HSE who would whistle blow and I feel there’s a lot of fear in the HSE of proposed whistleblower legislation,” he said.
“Our enemy is ignorance of what we do and why we do it,” he added.
Galway GP Dr Dan Murphy – who chaired the meeting – said that he hoped that the high turnout of GPs would demonstrate the widespread opposition among GPs to the contract and call attention to the general issue of the crisis in general practice.
“These meetings are part of our on-going campaign to get out the message that general practice is in crisis”, said Dr Murphy. “We have been happy with the response from Oireachtas members who have attended our meetings so far. It is obvious that the real story of the crisis that is happening in general practice is being whitewashed by their party establishments, but TD’s and Senators attending our meetings are beginning to understand what is really happening.”
Dr Sinead Murphy said: “We are all in this together, and if the Department of Health want solutions they need to talk to the people that actually implement and deliver quality service to their patients every day.“
The Oireachtas members who attended the Galway meeting were Eamonn O Cuiv TD (FF), Sen Fidelma Healy Eames (FG), Sen Hildegarde Naughton (FG), Sen Trevor O Clochartaigh (SF), Derek Nolan TD (Lab), Noel Grealish TD (Ind), Brian Walsh TD (Ind), Sean Kyne TD (FG), Ciaran Cannon TD (FG), Micheal Kitt TD (FF), and Colm Keaveney TD (FF).
Most of the Oireactas members told the meeting that they were shocked at what was happening in general practice and vowed to bring the message of the meeting back to their parties.
Senator Hildegarde Naughton reflected the views of many of the Oireachtas members by saying: “The over-arching message from this meeting is that we need to have meaningful negotiation with general practice.”
Noel Grealish TD said that HSE ‘propaganda’ on GP salaries had to stop, while Senator Fidelma Healy Eames said that the contract as proposed was neither workable or safe.
The presentations were followed by several contributions from the floor.