Patient safety and the future of general practice as we know it in Ireland is being put at risk by plans to extend free GP care to the under 12s, the National Association of General Practitioners (NAGP) has warned. As the government is determined to continue with this ill-thought out policy, regardless of its consequences on patient safety, the NAGP feels that it has no choice but to ask its 1,450 GP membership to consider capping the number of patients they see daily for patient safety factors.
This was not a decision the Association has entered into lightly but we are trying to defend our patients’ rights to receive the high quality care they deserve, stressed Dr Yvonne Williams Chair of Communications.

“At this point we are simply asking members to consider this course of action so that patients can continue to be seen quickly and treated safely. GPs are increasingly struggling under the strain of an ever increasing workload with a high risk of burning out. This is even before the winter begins which is the busiest season in healthcare annually The stark reality is that promising free care to an estimated 200,000 additional children will make patients less safe and will fuel the exodus of doctors from primary care,” Dr Williams said. “Despite cut, after cut, doctors have maintained services for the sake of their patients, with many working over 60 hours a week, but GPs can no longer simply maintain this simply to support government’s electioneering schemes. We have tried to explain our concerns to Minister Varadkar and Minister Lynch about what these plans will mean for our patients safety as we head into the winter months but government is ignoring pleas from us and our patients.”

GPs are already forced to spend less and less time with their patients, with fears that this is negatively impacting on chronic disease management and mental health issues which leads to increased prescribing & referral rates. The Association’s pre budget submission indicated that half of Irish GPs are now forced to spend less than the internationally recommended consultation time with their patients. As the population ages, this pattern will only worsen.  Ireland is no longer considered an attractive option for medical professionals to work. In a recent survey of GP trainees, only a quarter indicated that they would remain in Ireland and a third of GPs are planning to retire within five years.

Rolling out free GP care to another large population cohort based on age rather than medical need or income when general practice is on its knees seems incredibly unfair on patients with health problems and lower incomes, said Dr Williams.

“We cannot recruit or retain GPs in Ireland, with the current workload. For the first time in the history of the state, it is common place for large areas of rural Ireland to be left without a GP. Furthermore, the HSE cannot say whether free GP care for the under sixes or over 70s is even working, never mind cost effective when they have to the best of our knowledge failed to undertake any analysis of the scheme.

“Under the Medical Council’s Guide to Professional Conduct, doctors are obliged to act in the best interests of their patients. This obligation takes priority over responsibilities to colleagues and employers. We deeply regret that we are forced to consider this course of action, but by asking members to cap the number of patients they see, doctors are standing up for a health service that is fair and accessible for the communities they serve.”

Dr Williams added that extremely ill patients who present at practices will be seen and given treatment as always.
Despite the government’s claims that free GP care represents a panacea to the country’s health challenges, a substantial number of the eligible under sixes have yet to sign up for the scheme.

The continued campaign to exclude the NAGP from contract talks is also deeply insulting to the patients of 1,450 family doctors, who are working tirelessly for the betterment of their communities.

“This represents a serious breach of trust given repeated promises from Minister Leo Varadkar on this issue,” added Dr Williams. “We are looking forward to meeting with him and Minister Lynch in the coming weeks as they had agreed in writing to meet with us this autumn” “Prioritising patients by age ahead of those with serious physical & mental health problems and ahead of the less well of is unjust  when general practice is already wholly unjust when general practice is already at maximum capacity, and in real crisis.”

The motion will be one of several options to be put to members at the forthcoming national meeting on Saturday November 7th at the Hotel Minella Clonmel in Tipperary. This meeting will be opened to all GPs & GP trainees giving the nature of the crisis. This motion was approved for recommendation by the NAGP’s executive council in an emergency meeting on Friday October 16th.