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'Slow drive' Dublin protest as young GPs say 'they will not stay in the country' under current contract

The NAGP says 700 GPs are set to retire over the next five years.

GP Bríd Walsh and NAGP President Maitiú O Tuathail.
GP Bríd Walsh and NAGP President Maitiú O Tuathail.
Image: Conor Healy

Updated Feb 6th 2019, 2:25 PM

GPS ARE PLANNING a rally and a “slow drive” around Merrion Square in Dublin this afternoon to protest against what they say is the “killing of general practice” 

About 500 people are expected to attend the protest across from Leinster House with the National Association of General Practitioners (NAGP) saying a lack of investment is threatening patient access.

The NAGP says there are over 700 GPs due to retire in the next five years and that there are not enough young, newly trained GPs to replace them.

The union estimates that about 90-100 full-time GPs are trained each year but that surveys have shown that 45% “plan to emigrate for better pay and conditions”.

Speaking a press conference ahead of the protest this afternoon, NAGP president Dr Maitiú O Tuathail said that he has seen how young GPs increasingly don’t view Ireland as a viable place to practice.

“When I started off in medical school, if a job came up in rural general practice there were between 30, 40, 50 applicants for that. Nowadays the vast majority those go without a single applicant. So GPs don’t see general practice as a viable specialty because it is not viable,” he said.

We did a survey last year and found that 50% of GPs are in debt trying to maintain the current level of service they’re providing at the moment. And GPs see that and what they’re deciding to do is emigrate rather than staying in the country. 

The NAGP is calling for the immediate reversal of the FEMPI cuts that were introduced in 2008 and remain in place. It says this would amount to an extra €160 million in funding put back into general practice and would “resuscitate” the sector.  

NAGP chairperson Andrew Jordan said that an extra €550 million is then needed to expand the primary care sector, allowing GP practices to provide extra services to take pressure off hospitals and other healthcare providers.

“Right now we need the €160 million that was taken from general practice ten years ago and put back into the resources. And this is money for patients, this is money for the community, we’re not talking about salaries into general practice,” said NAGP CEO Chris Goodey.

PastedImage-44556 NAGP chair Andrew Jordan. Source: Conor Healy

The union says that there are now 26 communities across the country with no GP service at all and that this could increase.

In counties like Kilkenny, Mayo, Roscommon, and Longford, the NAGP estimates that 40% of GPs will have retired by 2024. In Leitrim it could be as high as 50% and other areas will also be affected.

O Tuathail added that there are other areas where GP practices are unable to take on new patients because they are overstretched. 

He added that the current contract GPs have with the State, which dates from 1970s, is out of date. Particularly in a profession that is seeing an increase in female GPs.

“Once general practice is resuscitated and we’ve got the reversal of FEMPI we can talk about a new contract but we need a new contract, we don’t need bolt ons to the current contract that we have. The current contract is totally unfit for purpose, it’s almost 40 years old, 50 years old,” he said.

My generation will not stay in the country if the current contract stays as it is, it doesn’t entitle GPs to maternity leave, it doesn’t entitle them to sick leave. It requires them to work 24/7, 365 days year. That is both unrealistic and unsafe.

NAGP_004 (1) Kerry GP Bríd Walsh Source: Conor Healy

Speaking to reporters, rural GP from Ballyheigue in Kerry Bríd Walsh said that she was only able to start a practice by teaming up with another local GP.

“I took over a list that was vacated three years ago at the time it was left vacant, nobody wanted to apply for it. There were three rounds of interviews before finally there were actually applicants. Myself and another female GP combined our practices together.”

I was very fortunate in that I was able to attach my business to hers and the income that she was making sustained me in the first couple of months when I was waiting for my payments from the department and from the HSE. Had we not taken on that list, the entire north Kerry head would have been without a GP. 

Walsh also spoke about the “astonishing” costs that go with setting up a GP practice, something she admits not even being fully aware of herself beforehand.

“They’re something I wasn’t aware of and I’m a qualified GP and I didn’t really appreciate it until I went into partnership.”

“So we get paid for our medical card patients, our GMS patients, a capitation fee per year. That fee is a one-off payment, irrespective of how many attendances a patient may have.” 

And out of that we pay tax, so you half the fee you may say. Then for my practice, for example, I have three doctors, so you pay three doctors’ wages. I have three nurses, I have four secretaries, a practice manager, two buildings, two rents, heating, electricity, telephone, insurance for doctors, nurses and public liability. 

“The money we make from our GMS contract doesn’t cover in any way, shape or form those outgoings. So we charge for the service we provide not because I particularly want to, but because I simply can’t pay my staff if I don’t make money.”

“That was the part of the job I never really appreciated when I took up the role, I never appreciated that it was an SME as well,” Walsh added.

Today’s slow drive around Merrion Square begins at 2pm and GPs will then congregate at Molesworth Street across from Leinster House for the protest.

Speeches will be delivered by NAGP members and a number of opposition TDs. 

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Rónán Duffy

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