Annie Hoey (Labour) | Oireachtas source

I will not go back around as we have spoken a lot about training. The figure of 350 GPs out of a potential 1,000 GPs is a fair whopper of a number, and it could be substantial.

Reference is often made to bringing in doctors from abroad. At a previous meeting we had a brief conversation about the ethics of recruiting doctors from overseas and the impact of depleting other countries, and particularly developing countries, of their medical expertise, especially given some of the limited growth opportunities Ireland has for doctors who have come from abroad. This is slightly outside the focus of GPs but it reminded me that we had that conversation. We cannot be outside of the training opportunities for people moving globally. This is very important. We cannot rely on bringing people in. There is an ethical concern and we have discussed this topic at a previous meeting. I just want to flag it here.

Reference was made to women's healthcare, and health care for pregnant people. We are talking about service provision and people being able to access care. Do the witnesses believe that the conscientious objection around abortion care is resulting in a depletion of care for pregnant people?

Would the witnesses say it is a good thing, particularly for those in rural areas? For example, I note that Sligo has no GP that we know of who will provide abortion care. There may be care provided under the radar. People are forced to either travel across their county or outside of their county in order to access timely care. I assure the witnesses that I am not asking for their personal opinion on the merits of conscientious objection, but rather asking them as representative organisations whether they are concerned that this severe lack of options for women or pregnant people in this area. It becomes a bit of a postcode lottery as to whether or not people are able to access timely care.

I have spoken to a few GPs and one of their big concerns is about how they can interact with and support people with mental health issues. They told me that there is essentially no primary care mental health service in Ireland. They noted that people who are not in the GMS have to pay the market rate if they are in crisis and there is no embedded model of care. They stated that mental health accounts for the bulk of GP workload but they are left on their own. They referred to the lack of availability of psychological therapies for non-GMS patients and the months-long waiting list. The cost of psychotherapy for a year can be over €1,000.

These GPs also raised the lack of social management options and told me that nothing is embedded in GP primary care for key workers, or anything like that. In their statements and briefing notes, the representatives of the IMO and ICGP spoke about the more embedded, broader model of care that people will be able to access in GP clinics. I ask them to speak on the issue of mental health. The GPs I spoke to said that one of most devastating things is not being able to offer the mental health care that is crucial at the moment. I put that question to Dr. Ní Dhálaigh and Dr. Quinlan.