Michael McNamara (Clare, Labour) | Oireachtas source

This issue concerns Shannondoc, which is a general practitioner, GP, co-operative based in County Clare that provides out-of-hours services to cover what GPs normally do during office hours in the evening and at weekends. It is an important service but there have been repeated rumours throughout County Clare of various reductions in Shannondoc services in west Clare, Shannon and elsewhere. Thankfully, this has not come to pass and it is important to state there has been no reduction in the Shannondoc services thus far but nevertheless, it also is important to acknowledge there is a great deal of pressure on the services Shannondoc provides because of GP shortages. When the present Government was elected, there were 20 GPs operating out of north and west County Clare but that number has now fallen to 15 and therefore, the number of GPs Shannondoc can pool and put on a roster in the evening is reduced. While this might not appear to be so important, the ambulance service is already at breaking point or at least is at the very edge of what it can achieve, and likewise the accident and emergency facilities in Limerick. While I thank the Minister of State, Deputy Coffey, for coming into the Chamber, I appreciate he is not a Minister in the Department of Health and consequently may not be aware of the overcrowding situation in the accident and emergency unit, but it is at an unacceptable level.

If people are unable to get a doctor to call out to them at night time, they have no alternative but to call an ambulance or make their way to an accident and emergency department and join the lengthy queues there. It is a serious issue which arises not as a result of a lack of HSE funding of the service but owing to a lack of doctors practising as GPs in the area. Many of the GPs currently working in the area are elderly and are, understandably, less inclined to work long hours. Very few of the GPs coming on stream these days are going into rural practices across County Clare.

Doctors and graduates of medicine in Ireland generally earn a lot of money. They earn what would appear to me to be a great deal of money and it would certainly be a huge amount in comparison with the earnings of most of the people I represent but it is still a lot less than they can earn in Canada and in other countries across the world. For young doctors who are not tied to any particular place and do not have a family of their own, the option of going to work in the health service in another country is very attractive and that service is probably better funded. There is little this Government can do to stop that happening. It would be wrong to try to stop anybody emigrating. We had a referendum a long time ago, the aim of which was to stop certain people leaving the country, which would be a preposterous proposal to most.

Older doctors also earn a lot of money. Many older GPs were encouraged by the HSE to set up GP practices in which they invested very heavily in terms of equipment and so on and in respect of which they received funding from the HSE. However, that funding has been reduced. Every backbencher has a constituency office. I assume Deputy Coffey, although a Minister of State, still maintains a constituency office. Constituency offices are funded by the Exchequer such that Members are not required to pay for them. While GPs were encouraged by the HSE to invest in their facilities and in that regard took out mortgages and so on, they now find that the funding they receive is a lot less than they anticipated when they took out loans and so on. There is a real problem in relation to general practitioners in this country. If there are not sufficient GPs, people go elsewhere with their health problems. They clog up accident and emergency departments and inevitably rely on the ambulance service, which is already over-stretched.

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