Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank Deputies McGinley, Doherty and Pringle for raising the issue as it gives me an opportunity to update the House on the matter. I am taking the debate on behalf of my colleague, the Minister of State, Deputy Kathleen Lynch, who is on Government business elsewhere.

The NowDoc GP out-of-hours service is a partnership arrangement between the GPs affiliated with the NowDoc service and the HSE. The service provides out-of-hours GP care to patients in the north-west catchment area. In November 2013, the GPs engaged with Caredoc Ltd. to manage the GP out-of-hours services in Donegal, south Leitrim and north Roscommon on their behalf. The HSE entered into discussion with Caredoc and the GPs regarding a formal service arrangement in November 2014. A number of issues were discussed to facilitate the development of a sustainable and efficient service into the future. These included further development of the clinical governance structures, ICT development, liaison and monitoring arrangements, GP deployment arrangements and funding. An independent facilitator was put in place in early 2015 with a view to having a memorandum of agreement signed by the parties by the end of May 2015.

It was also agreed that the issues of GP deployment and funding could only be addressed through a comprehensive review of the current call activity and GP resources. The Caredoc GP clinical lead reviewed the available data and in recent weeks and the HSE has validated this to ensure that call activity data is accurate for the agreed review period and reflects the predicted call activity levels. The completed review indicates that there are few calls after midnight on the red-eye shift and that the current level of GP resources allocated to this period could be safely reduced while maintaining the service response times in line with the current performance standards and well within the response time standards of the Royal College of General Practitioners. The review also indicates that the red-eye GP resource in Carrick-on-Shannon and Mountcharles would remain as per the current arrangements, with the potential to reduce the duty GPs in the north Donegal area by one during the red-eye period. This measure is also being considered in the context of providing GP cover arrangements that are sustainable into the future and to assist in addressing difficulties that currently exist in recruiting sufficiently qualified and vocationally trained GPs to cover red-eye shifts. The possibility of having such a reduction implemented over two phases has also been considered to allow phase 1 to be analysed in detail before proceeding to phase 2. The arrangements for phase 1 would see a reduction in cover for the five weekday nights only, as these are not as busy.

Following the review, the GPs and Caredoc have indicated their intention to submit a formal recommendation regarding GP deployment in the out-of-hours service. As part of the consultation process with stakeholders, the HSE, the GP clinical lead and Caredoc personnel met with Oireachtas Members and Donegal County Council members of the Western Health Forum last Friday to discuss the review process and possible outcomes. The HSE, GPs and Caredoc continued their discussions today. All parties will now reflect on the contributions from elected representatives to ensure that agreement can be reached on service delivery arrangements so that services continue to be provided in a safe and efficient manner. All services will remain as per the current arrangements until this process is concluded.

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