General Practitioner Services – Topical Issues

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Speech by Leo Varadkar TD, Minister for Health.  I wish to thank Deputy Fleming for raising this issue.  It provides me with an opportunity to update the House on this matter.

The HSE is committed to the provision of quality General Practitioner Services through the General Medical Service (GMS) GP Contract.  GMS GP posts are filled in line with the HSE’s Human Resources Recruitment Guidelines. 

Periodically, challenges can be experienced in relation to the permanent filling of GP posts.  In areas where this challenge is experienced, every effort is made by local HSE management to ensure the provision of GP services to all GMS patients.

The retiring doctor in Borris-in-Ossory advised the HSE of his intention to resign from the GMS Scheme in November 2014.  The GP’s practice is a single-handed, rural practice with a GMS panel size of approximately 830 patients.

The GMS panel was advertised by open competition and interviews took place in late 2014.  Two applicants applied and both were placed on a panel following successful interview.  Both candidates subsequently declined the offer of the position.

The position was subsequently re-advertised by open competition, in early February, 2015 and interviews are scheduled for 4th March, 2015.

The retiring doctor has agreed to continue in post at least until after the March interview and the selection process is concluded, allowing time for the post to be filled.

While GP numbers are keeping pace with overall demographics, this does not always prevent shortages occurring at local level.  GPs, once qualified tend to work for existing GP practices or as self-employed contractors – and are free to decide where to establish their practice.  Isolated rural areas and deprived urban areas, very often with limited private practice opportunities, may sometimes find it difficult to attract GPs to fill vacant posts.

The HSE is seeking to address this issue at present with the medical organisations with a view to developing practical measures – including reorganising lists with existing doctors in local areas, and through the adoption of more flexible contractual arrangements which would encourage young GPs to work in such areas. 

The Department and the HSE are currently in discussions with the IMO about the introduction of flexible/shared GMS contracts.  The possibility of extending the current GMS GP retirement age from 70 to 72 years is also being considered.  The introduction of flexible/shared GMS contracts would provide more family friendly working arrangements better suited to younger GPs who have young families, thus making it more attractive to pursue working in the GMS Scheme. 

Under the Programme for Government, it is intended to develop a new contractual framework for GPs which will be more suited to current needs and will facilitate the planned development of Primary Care Services.   Substantive discussions on a new GMS contract for GPs will commence shortly with the Irish Medical Organisation. 

Mechanisms for encouraging GPs to set up practices in rural and urban disadvantaged areas will be considered, as appropriate, in the context of these discussions.

In the meantime, where GMS GP vacancies arise in an area, the HSE will take the necessary steps to ensure that continuity of service to GMS patients is maintained.