Rural GP sustainability
Deputy Lawless said rural GP practices were still under strain despite programme commitments. The Taoiseach replied that GPs are self-employed contractors, the rural practice allowance had increased, and general practice is moving toward group practice and ongoing contract talks.
The Taoiseach's closing comments lead me nicely to the next question. On health, the programme for Government guarantees the future sustainability of GP practices in rural Ireland. The Taoiseach mentioned the number of doctors being recruited. However, in rural Ireland we are not seeing them. There appears to be a policy at HSE level to consolidate services around primary care centres in urban areas. While I certainly welcome the primary care centres as a positive, they are not a substitute for a local GP for those, often elder and immobile, who live in rural areas. What practical steps have been taken under this commitment to fulfil this sustainability? The rural practitioner allowance, which was previously a viability cheque for GPs to operate in such situations, has been discontinued and the hiring practices of the HSE have been to delay and prolong uncertainty about certain practices which has led to their demise. What steps are being taken under this commitment to support rural GP services?
Comment on this
GPs are not recruited. They are self-employed contractors. It is slightly different to doctors who are employed in hospitals and in the public health service.
The rural practice allowance has not been discontinued. It has actually been increased, and it is easier to qualify-----
Comment on this
It is more difficult to get it. The criteria have changed.
Comment on this
----- than it was previously. I myself signed that order 18 months ago. The kind of GP that my father would have been was willing to get up and go out on house calls every night, would come home to find my mother would have a message for him to go out again, and would work every weekend. The world has changed and lifestyles have changed. Also, the nature of general practice has changed and one can provide a better quality of care in group practices now than a single-handed GP can, except for a small number of extremely dedicated doctors who still do that.
There are contract negotiations under way currently between the IMO and the Minister for Health. One matter that is under consideration which might work for rural areas is having a salaried GP, somebody who would be for the first time a State employee as opposed to a private contractor. I do not know whether doctors will want to do that or not. The world of work has changed and doctors may not be willing to do in the future the kind of work they were willing to do in the past.