Dr Donal Punch, who has a purpose-built surgery in Mayfield in Cork city, is among a growing number of family doctors who insist they have not been “crying wolf” about the huge negative impact on their income after a series of cuts in state fees for medical card patients.

“People cannot see me for an average of two to three days. It has been going on for nine to 12 months,” he revealed.


“I reserve a couple of slots for people who are urgent and cannot wait. But once they are filled there is only so much I can do.”

Dr Punch has 1,200 medical card patients and they make up the majority of the people he sees.

His wife, Dr Una Barry, who is also a GP, works part-time in the practice and has a list of around 70 medical card holders.

The increased pressures on GPs are being added to by hospitals which are now off-loading many more patients – who might previously have been admitted to a ward for tests – to family doctors.

“Now if they are admitted at all it is for the least amount of time. And they bounce back to us very quickly,” he added.

Dr Punch said his practice was so busy that he did not have the time to do house calls. “Doctors are not even paid a cursory amount under the medical card scheme now for house calls between 8 and 6pm,” he added.

There is the advantage of patients in Cork city being able to go to the emergency department instead, but GPs in rural areas still have to make long journeys for home visits. Dr Punch is among nearly 700 family doctors who have now joined the new National Association of General Practitioners (NAGP) which has been reformed to lobby on behalf of GPs alone.

The NAGP has appointed Chris Goodey as its chief executive with a headquarters in Dublin and it aims to get a negotiating licence and act as a trade union.

The only other trade union is the Irish Medical Organisation (IMO) but it represents all grades of doctors and it has been in turmoil over a pension dispute with its former chief executive.

Mr Goodey said GPs needed to have a union of their own because they had lost out so much.

The latest round of cuts will reduce their income by over €30m a year.

GPs are not covered by the Haddington Road Agreement, and their last contract talks took place in the late 1980s. There are around 3,000 GPs and the NAGP needs 1,000 members to get a licence.