Michael Healy-Rae (Kerry South, Independent) | Oireachtas source

I thank the Technical Group again for giving me some of its speaking time. General practitioners from around the country, who have provided an excellent service to their patients over the years, are coming to Dublin this morning for a protest. It is unprecedented, in my memory, for hard-working GPs to take time out of their busy schedules to engage in such a strong and genuine protest about the detrimental effects of Government policies on their practices. Every politician who is elected to this House knows and appreciates the value of local GPs. Unfortunately, these doctors have had to endure a 40% reduction in funding for patient services over recent years. Many things that have happened are making the operation of GP services very difficult. Distance codes for call-outs have been abolished. This is affecting GPs in rural areas. The people of Feakle have been trying to get a GP to come to the area. Any GP should be able to make a living by operating out of such an location. Unfortunately, it has not been possible to get a doctor to go into the area. It is a fright to think that the difficulties being faced by GPs are making it hard for them to survive financially. The rural allowance, which used to be available to a GP who had a certain number of patients within a three-mile radius, has been abolished.

I wish to refer to the unworkable contract that doctors are being asked to sign up to. Perhaps I should say they are being coerced or forced into doing so. Along with some of my colleagues, I have met large groups of GPs from County Kerry who have explained to us in great detail that certain elements of the document are impractical. The doctors will not sign up to the proposal that is before them. Having read and studied the document, I have seen the gagging clause that will prevent GPs from advocating for the rights of their patients. One of the small and simple things included in the document is the imposition of certain conditions on doctors' surgeries. The walls and floor coverings, etc., will need to be of a certain type. If this approach is taken to its logical conclusion, it is clear that if one tells a doctor he or she cannot treat a patient in a room that is not of a certain standard, one will do away with the home visit. When a doctor goes to a person's home, it is unlikely to meet the standards that the doctor's surgery will have to meet under this proposal.

The waiting lists for home visits will be very long in the future because of the lack of GPs. We do not have enough doctors in this country. The Minister of State, Deputy Kathleen Lynch, will be aware that a person who wants to see his or her GP today will be able to do so. That has always been the case. If this unworkable document is implemented, I fear that future patients who want to see a doctor today will not be in a position to do so. That was never the case before now. If a person in any part of Ireland wanted to see a doctor on any given day, he or she would get to see one. This great service was provided out of hours. Doctors called to people's homes. Very bad weather conditions in the winter months did not stop them from calling to see their patients.

I appreciate the opportunity to speak on this matter on the morning that GPs are taking the unprecedented step of coming to the Dáil to let the Government and the people of Ireland know that they are upset. People always had the idea, found in the expression that "the doctor is well off, he is doing fine, there is no problem with him". I know GPs who are struggling with financial difficulties because it is so hard for them to run their practices. Irish GPs have 24 million contacts with their patients each year. One million of these contacts take place out of hours. The out-of-hours service provided by GPs has always been excellent. Approximately 95% of problems are sorted out by GPs without further referral. It is great that a person with a medical difficulty can go to his or her GP and get sorted on the day without having to be referred anywhere else.

Just 2.3% of the total health budget is spent on GP care. This compares with an equivalent figure of 9% in the UK. As I have said, funding for patient services has been cut by 40% over the past five years. GP costs have not remained unchanged. They have increased dramatically, as the Minister of State knows. In light of the additional cost burdens faced by GPs as they try to run their practices, it is disgraceful that the remuneration paid to them is now at the same level as it was in 2002. I am concentrating on the situation of GPs because it is vitally important. It is hard to believe GPs are struggling through such tough times at present but that is the case. I know other politicians will have had similar experiences in their constituencies. Every Deputy knows the local doctors. I am sure they will say the same thing. I am highlighting this in the House this morning because something needs to be done about it.

When I asked the GPs to make suggestions about amendments to the document they are being asked to sign up to, I was told in no uncertain terms that it is unworkable. It is not feasible to implement it. I was told it needs to be torn up. We should start again. I ask the Minister of State, Deputy Kathleen Lynch, and her senior colleague, the Minister for Health, to examine the GP contract with a view to amending it. They need to work with the GPs and their association to agree a workable document that will encourage young newly-qualified doctors to stay in this country. It is a shame to think that after we have educated our young doctors, the only realistic option open to these young men and women is to go away and practice in some other part of the world, rather than staying in Ireland. This will lead to some very bad situations. I know doctors who should not have retired, but who did so at an early stage because they think the current position is unsustainable. They decided to get out while they could. Older doctors are pulling out early and younger doctors do not want to go into the profession in Ireland because they do not think they can make a living. That will be detrimental to patient care. We will pay a very high price for this in the future, particularly because we have an ageing population. Older people who try to live at home have always relied on the good services of GPs. They will no longer be able to avail of those services on a daily basis as they might wish. That will surely be a detrimental situation.

I ask the Minister of State to use her common sense and her knowledge of the situation on the ground. She knows as well as I do that her local general hospital - Cork University Hospital, which provides a great service - is under immense pressure. I will give an example of what is happening in Kerry General Hospital at the moment. In recent months, the blood laboratory at the hospital has been experiencing trouble in processing blood tests. This has led to delays in patients finding out about the results of their samples. These things should not be happening in a modern health service. I hate to be critical of anything - I would prefer to be positive when I stand up here - but I have to criticise situations that are wrong.

11 o’clock

I have had nurses pleading with me to stand up in the Dáil and fight for them and their patients about whom they are extremely worried. Nurses are under the most unbelievable pressure on the wards, trying to take care of patients. All they are interested in, at the end of the day, is taking care of their patients. That is what is in their blood, if not their DNA. They are finding it genuinely difficult to do so, however, because of cuts. Why are we continuing to spend so much money on agency nurses instead of hiring full-time nurses? If one does the sums it is surely obvious that it costs more to pay agency nurses than to employ young people on a full-time basis. We must increase the numbers working in our hospitals.

On a positive note, some of the services in our hospitals have improved enormously in recent years. People who would have died in the past due to certain conditions now have a better chance of surviving. However, what is missing from the system is the person working in our hospitals as a nurse or doctor. The Minister of State knows that. I know she would not try to cover up for the Government on this issue and would tell the truth in this regard. She has personal experience of this and has seen it herself. As the Minister of State knows, cuts are also having a detrimental effect on our psychiatric services. I ask that the Minister of State takes on board the points I have made and fights with the people on that side of the House to ensure better services are provided to patients who are of paramount importance.

See this speech in context