The National Association of General Practitioners (NAGP) has said that figures outlined in the Irish Medical Council reports published on Thursday highlight the critical shortage of GPs and emphasises the urgent need to adequately resource general practice.
The Council’s Medical Workforce Intelligence Report states that there are 63.1 GPs per 100,000 population practicing medicine in Ireland. This figure falls well below international best practice of 80 per 100,000 population.
The current shortage of GPs is at crisis level. To compound the issue further only 74.2% of all GPs registered with the Council are practicing full-time. 915 GPs have stated that they plan to retire or emigrate in the next 3-5 years which will see this existing shortfall almost double.
Dr. Andy Jordan, NAGP Chairman, said, “We are training our GPs for export and relying heavily on internationally trained GPs to fill the gap. We must create an attractive work environment to retain our highly skilled GP trainees. We are not training enough GPs to address the current shortfall which is predicted to almost double in coming years”.
Irish medical programmes are training some of the best GPs in the world but the Irish College of General Practitioners (ICGP) states that only one-third of GP trainees intend to work in Ireland. The Medical Council report found that our reliance on international medical graduates is among the highest in the OECD accounting for almost 38% of the workforce.
Dr. Jordan continued, “Rural and deprived inner city areas and single handed practices are bearing the brunt of the GP shortage”.
General practice delivers 22 million consultations every year, projected to increase to 33 million within five years. The number of contacts provided by GPs is ten times that of hospitals. The expansion in demand for GP services is due to the increase in the number of Medical Card Patients and the increase in the number of elderly frail and co-morbid patients.
A LHM Casey McGrath report commissioned by the NAGP in 2015 estimates that 2954 GPs are currently working in Ireland. To meet the increasing demand, we would need 4264 GPs by 2021.
Dr. Jordan commented, “It’s clear from the projections outlined in the LHM Casey McGrath report that we need to, not only start retaining the GPs that we are training, but we urgently need to start training more to address the increasing shortfall”.
GP Practice Nurses
As we move towards better resourcing of primary care there is a need to develop the nursing capacity in general practice to assist in new models of care for chronic disease. GP-led primary care can provide better care and cost savings to the state. The move from managing chronic care in a hospital setting into general practice will take time but should be resourced by the recruitment of extra nursing staff within general practice.
The NAGP want the current number of practice nurses to at least double. This is necessary in order to reach the ratios of practice nurses per GP in other successful GP-led primary care systems. The addition of extra primary care nurses would assist in enticing GPs back to our shores.
New GMS contract
The reports’ findings highlight the urgent need for a new GMS contract. A new contract would make a career in general practice in Ireland a viable and attractive option for both medical graduates and current practitioners, who are at breaking point. An adequately resourced GP-led primary care system is key to reforming the health service.
The Council’s Your Training Counts survey found that 1 in 5 trainee doctors say they will not be practicing medicine in Ireland in the future. We need to improve conditions in general practice to entice these trainee doctors to stay in Ireland.
The Council received 369 complaints about doctors in 2015. The NAGP contend that this figure naturally fluctuates annually. In 2013, the Council received 400 complaints and in 2012, it received 423 complaints.
Dr. Andy Jordan addressed the figures, “Fluctuations in the number of complaints is to be expected. It is important to use the information in the Medical Council’s Annual Report to improve doctors’ approach to patients. It is also important to note that in 90% of these complaints, the doctor is exonerated”.