Dr. Karena Hanley:

We know there will be a shortage of approximately 1,000 GPs in the next ten years. That figure comes from a national manpower planning study. Dr. Kerin spoke about the loss of trained doctors as soon as they finish GP training. It is most important that we look at ways of retaining them as well as producing more doctors. Let us look at solutions for retention. General practice is an attractive career. Drop-out rates during GP training are low but GP trainees fear that Irish general practice is not a viable career choice. General practice in Canada, Australia and New Zealand is better resourced and those countries actively recruit here. Their agencies are making it easier for our trainees to go. As well as the economic loss it is a cause of sadness and ill feeling. Emerging GPs want to do good chronic disease care for their patients in the community if appropriately resourced.

In terms of gender, under half of the general practice workforce is female. Two thirds of women doctors work full time but they tend to work part time in their 30s, which is a time of intense child rearing. A proportion of male doctors also work part time but there is a lack of flexible working options in the current GMS contract. Some doctors who are employed by a practice do not hold a contract with the State. Those doctors often do not receive any maternity pay or sick pay, as struggling practices now cannot afford to pay them. Much better terms of employment are available to young doctors in neighbouring health systems in the UK, Canada and Australia. As we have heard, access to diagnostics will help. Some improvement in access to ultrasound was achieved in some areas of the country in 2016. That is good but we need to build on it. Some older GPs intend to continue to practise beyond their contracted retirement age. That needs to be welcomed, planned and supported, with flexibility in the contract.

I will now turn to recruitment. The national doctors training and planning, NDTP, unit tells us we need 100 more GPs to be trained every year. The programme for Government agrees with that. The ICGP supports that goal, and can deliver it, if resourced. The ICGP will continue to work with the NDTP and primary care to increase GP training places. We are currently training 172 GPs per year. In the past six austere years, the ICGP delivered a 43% increase in training places with barely any increase in resources. The dilution of GP training must be avoided as dilution will result in less resilient GPs with fewer skill sets, and will not help retention.