Mattie McGrath (Tipperary South, Independent) | Oireachtas source

I am disappointed the Minister for Health is not in the House to take this Topical Issue. I know he is not abroad because he was in the House earlier today. While I welcome my colleague from Waterford, Deputy Coffey, this is not his area of responsibility.

On 25 September 2014, the National Association of General Practitioners, NAGP, took to the streets outside this House to protest over cutbacks that have closed rural GP practices and forced newly qualified GPs to go abroad to work. In the intervening period, nothing has changed. In fact, the situation is much worse. Rural GPs, who have already experienced a 40% cut to their income as a result of cuts to fees and allowances introduced under the Financial Emergency Measures in the Public Interest Act 2009, are still expected to operate without the guaranteed provision of a rural practice allowance and this is patently unfair.

The Minister of Health was urged in 2014 to redirect just 2% of the health budget to general practitioner services every year for the next three years to try to reintroduce parity of esteem for general practitioners. The NAGP has confirmed that up to 32 rural GP posts remain unfilled. Government policies are posing a serious threat to the health of people in rural areas and its unwillingness to fund the rural practice allowance has prevented doctors who would like to practice in rural areas from doing so. It was understood for decades by various Governments and the Department of Health that rural GPs need modest support structures in order to be able to function properly and remain viable and that is still true today.

In the case of Bansha, the incumbent, Dr. Madigan, is a wonderful doctor who has given sterling service, with her staff, the district nurses and health service staff. She has looked after the community very well. She is ill and has announced her intention to retire. I wish her well. However, we will not get a rural GP because people have been blindfolded and have their hands tied behind their backs.

The rural practice allowance is vital. There is no point in the Minister of State, Deputy Tom Hayes, coming to Bansha to reassure a public meeting that the Minister, Deputy Leo Varadkar, has promised to restore the general practice allowance in Bansha when there are 31 other posts to be filled, including in Clogheen in my own back yard, where a wonderful doctor, Dr. O'Reilly, who has been there 18 months cannot receive the allowance and is struggling to remain in place. When I had a parliamentary question answered by the Minister yesterday, he said it was a matter for the HSE. Someone is codding someone. Either the Minister is telling us fibs or the HSE is. The fact remains that Bansha general practice is in a serious position. Its GP is entitled to retire, but we are demanding that the post be readvertised and that the general practice allowance be included because it is needed.

I am told that there is a further complicating factor, although I do not have 100% proof of this, namely, that the HSE intends to charge rent for use of the health centre. This will make it completely untenable for any GP to use it. As a result, GPs are not applying for these posts. The GP in Gortnahoe wants to retire and a total of 32 doctors throughout the country are in this position, including in the Taoiseach's constituency of Mayo.

It is time the Government woke up to this problem. Pumping money into the so-called centres in Tipperary town and other areas where there are large practices is fine, but it is not fair to have people affected by the closure of rural practices, in particular, given that rural transport services are also being taken away. The regular transport service is not enough and people will be unable to get to Tipperary town, Cahir or Cashel. In addition, they currently have the comfort of knowing their GP and the staff in his or her practice, as well as the nurses, all of whom know the needs of their patients.

For many families the GP is the first line of defence, as the Minister of State knows. Whether it is a parent worried about a son or a daughter or a child worried about an elderly parent, the GP is the first person to be asked whether the patient is presenting with symptoms of, for example, Alzheimer's disease. The GP is the first line of defence and, in many cases, the only line of defence people living in rural Ireland have. We lost the post office in Bansha and have lost many other things throughout rural Ireland. We cannot and will not lose the general practice, too.

The Minister for Health should be here to answer this question. There is no point in there being a nod and a wink. The rural practice allowance must be restored in Bansha.

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