No GP service for middle-income people, regional health forum is told

HSE West has confirmed that a shortage of GPs in the region is making it difficult for people to receive medical care or get on a patient list with a doctor.

The matter was discussed after a representative from Tuam, Cllr Donagh Killilea, told the HSE West Forum this week that he had constituents who were unable to become registered with a family doctor in the area because no GP was willing or available to take on new patients.

He said that while those entitled to a medical card are also entitled to GP care, “middle-income earners who are above the income threshold to qualify for a medical card are being left without access to GP care and are being forced to use A&E and Westdoc out of hour services in order to receive medical care.”

The Chief Officer for Community Healthcare West, Breda Crehan-Roche, could only agree with the sentiments expressed, as she confirmed there is a crisis in GP retention, GP recruitment and GP availability at the moment.

Cllr Killilea said that there is a process in place for medical card patients but unfortunately, if you are not entitled to a medical card, there is no way to get into a GP.

“They are full to capacity right across the county as well as there being several retirements. I spoke to a carer who moved home from abroad last week who cannot get herself or her family onto a GP list; those middle income but below the threshold for medical card people, have to use A&E or Westdoc out of hours for health care. It’s hard to be sick when you cannot get into a GP.”

He wanted to know had the HSE the right to ask GP practices in Primary Care Units to take on additional patients or staff and added: “If you are in Galway today and move to Tuam, you can’t transfer; no GP will take you on; you have to commute up to your Galway GP; it is either that or go public through A&E - and we don’t want our A&Es to be used for GP services, but there is a certain amount that have to because of the situation.

“I understand that a lot of GPs are not taking on new clients and the only medical support available to those not registered with GP services is either A&E services or Westdoc out of hour services. Can the HSE confirm if the GPs that operate Primary Care Centres are obliged to take on new registrations. Because at the moment, retiring GPs struggle to offload their GPS list, or to get a GP come in and take over their practice; and some single GPs have been operating out of their own surgeries from 30 years ago.

“We are now focussing on a more GP-central practice approach, with other health services at the same locations, which is good, but there is nothing there for people to get on to a GP list - I am talking here about my own area of Tuam. It is a very basic need, of health care, and should be at the top of the list in terms of health services. I think the GP contract needs to be looked at, in terms of that they must take on a certain level of private patients.”

Chief Officer for Community Healthcare West, Breda Crehan-Roche, responded: “We enjoy a very good service with our GP colleagues, the situation here is about recruitment. There are GP vacancies we are having difficulty filling, and we are lucky to have the agency locum services that help us here.

“We are looking at all options to recruit additional GPs but also, to make it attractive to keep GPs staying in the service. We have for example a fellowship traineeship that will work with GPs and 50% with the college and we are hoping that will attract more recruits.

“There is certainly a difficulty there, in when GPs retire, others have to take on those patients. We are trying to do everything possible with the universities and the GPs themselves to try and retain and make the whole field more attractive. We are particularly tackling areas that are difficult to fill and working with GPs to look at best optimising of our services, such as with COPD and other targeted services. But this situation is not unique to the west, this is throughout the country.”

 

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