Increasing workload and lack of resources are forcing GPs to spend less and less time in consultations with worrying consequences for their patients’ health, the National Association of General Practitioners (NAGP) has warned in its pre budget submission. Shorter consultation times, the Association outlined, have been shown to lead to higher prescription rates, more referrals to an already overstretched hospital system, and negatively impact on a doctor’s ability to diagnose and manage chronic health problems.
“It is therefore vital that a GP has adequate resources to spend sufficient time to meet their patients’ needs,” the NAGP, which represents more than 1,400 GPs, said Dr Yvonne Williams spokesperson for the NAGP. According to a recent survey by the Association, the average consultation time for an Irish GP is 12 minutes, less than the 15 minutes recommended. Furthermore, it estimated that an additional 1,310 GPs will be required to keep pace with the expected increase in consultations.
However, increased workload and the Government’s policy of free GP care has not been accompanied by a similar investment in general practice. This, GPs fear, will likely lead to a deterioration in care in a number of areas and increase the numbers of Irish doctors forced to emigrate.
“If by the year 2021, the universal model is introduced, the total projected population of 4.88 million will be able to visit their GP free of charge. This is certain to increase the number of GP consultations per year,” the pre budget submission states. “In order to maintain the level of consultations available now, this would mean an increase in GP numbers from the current 2,954 to 4,264 by 2021, and a further increase in GP numbers to 4,411 by 2026.”
While many more GPs are required, the number of trainee places available every year is only 157. A significant number of these trainees also do not intend to remain in Ireland once they are qualified and it is also expected that a number of current GPs will be retiring in the next five years. A number of GP vacancies also remain unfilled throughout the country, with new GPs, concerned about the viability of these practices, reluctant to fill the posts.
“It is therefore highly unlikely that the number of GPs in Ireland by 2021 will be sufficient to maintain the current standards given the expected increase in the number of consultations arising from the introduction of the Universal GP Model of Care,” said Dr Williams.
In order for the Government to meet its own policies, general practice needs adequate and appropriate resourcing.
“The trends of practice closures and GP emigration need to be reversed” the Association states in its submission. “This can only be done by reversing the FEMPI cuts and introducing a range of measures that will allow Irish general practice to compete with other nations for the scarce resource of GPs. We ask that the Minister abolish the FEMPI cuts and invest further in general practice to prevent a looming crisis for patients in the primary care sector.”
The NAGP believes that with an ageing population, general practice will need additional investment of €542 million by 2021 and of €576 million by 2026. If this funding is not made available the problems of increasing waiting times, decreasing consultation times, and doctors forced to emigrate will continue, the Association concludes.