GPS HAVE CALLED for urgent action to address the shortage of doctors in general practice as they deal with an ‘overwhelming’ workload.
Doctors have said they are forced to turn away new patients because they are already struggling to maintain their services alongside the additional pandemic demands such as administering Covid booster shots to the over 70s.
Speaking to The Journal, Monaghan GP Illona Duffy said that she knows of some GPs who are now considering early retirement due to the extreme pressure they have been under throughout the pandemic.
“We’re seeing it in terms of shortages here in our own practice – two partners retired this year and we haven’t replaced them fully,” she said.
She said her practice is unable to take on new patients as doctors are already working long hours to provide services to their current patient load.
Dr Duffy said GPs have been under increasing pressure since the summer and this has escalated in recent weeks.
“We weren’t directly impacted by the HSE cyber attack but now we’re getting hundreds of letters, some dating back as far as April. They couldn’t print them off at the time so we’re getting them all now. That means extra work and calls to patients,” she said.
To help streamline the workload she said her surgery has been asking patients who want to book appointments to call at 8.30am on the day. However this has led to frustration among patients, she said, because there is such a demand for GP services that slots are booked up quickly.
“Patients are feeling like they’ve had enough of the lockdown restrictions, not being able to go places or see their GP when they want to, they want that checkup they haven’t had in two years and that’s a valid expectation but we have an ever in decline GP workforce,” she said.
“So people are getting fractious and the front of house staff are getting that from people.
On top of everything we’re trying to do the boosters for the over 70s, but we can’t do what we did earlier which was to do all day Saturday or close the surgery down for half a day. We need to maintain a normal service now so we’re trying to do it at the end of the surgery and that means a longer day for us.
Duffy said “every GP in the country is burnt out” and some colleagues did not get a chance to take a break at all this year.
Dublin GP and assistant professor in primary care at Trinity College in Dublin, Darach Ó Ciardha, said the increasing Covid-19 cases are putting pressure on GPs.
“Things are a little bit trickier this year in terms of patients with respiratory symptoms because there are a lot of non-Covid infections circulating as well. It can sometimes be a difficult conversation with patients in terms of trying to encourage them to get a Covid test, we’re meeting a bit more resistance than before,” he said.
Dr Ó Ciardha said the demand on the Covid testing system, particularly in Dublin, also impacts on GPs as patients who struggle to find appointments on the online self-referral system contact their doctors for a referral.
“It’s excellent that patients have been able to self-refer for testing and it’s a very important part of the response but we’re seeing pressure on the system and that has a spill over effect into general practice,” he said.
Ó Ciardha said there is a “serious issue” in terms of overall GP numbers as many have to turn away new patients.
“We’ve got a growing population and we’re not producing the amount of GPs we need. That impacts on the services we’re able to provide, it impacts on the number of practices in general and it has an impact on locum cover for annual leave and sick leave for GPs too.
Securing locum cover has become very difficult now, the fact is that many GPs that would have provided a locum service have moved into more medium to longterm positions in practices.
He said if the government wants to encourage graduates to set up new practices, additional support will be needed.
“Financially it’s a huge risk at the beginning for a younger GP to take,” he explained.
“There needs to be a re-imagining of supports for new practices to give them some security even just for the first couple of years while they are getting off the ground and building a list.”
The Irish College of General Practitioners has called for the establishment of a working group to address the need to significantly expand the workforce.
It said last month that the country needs more than 2,000 GPs over the next decade to meet population growth and the expected 700 retirements of older GPs during that time.
Last night the Irish Medical Organisation (IMO) said the government’s winter plan would “force more work out of our exhausted doctors”.
The €77-million plan aims to increase bed capacity, with 205 new acute beds, 275 community beds and 100 additional private community beds to be provided. It aims to increase palliative care capacity from 221 beds to 276 beds.
Around 4,000 GP diagnostics per week is being provided for under the plan, as well as the provision of out of hours GP services.
Dr Ina Kelly, President of the IMO said GP services are facing “unprecedented demand” from patients.
“The capacity is simply not there to meet demand and it is not all Covid-related,” she said.
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