Marcella Corcoran Kennedy (Offaly, Fine Gael) | Oireachtas source

I thank Deputy Dooley for raising this important issue. I can hear the anxiety he has conveyed on behalf of his constituents. That would be replicated by any of us in these circumstances. As the Deputy knows, GPs who are contracted under the General Medical Services, GMS, scheme must make suitable arrangements to enable contact to be made with them, or a locum or deputy, for emergencies outside normal practice hours. While there is no obligation on GPs to participate in GP out-of-hours co-operatives as a means of meeting the contractual requirement, such services have been developed and expanded over time and are now an essential part of our primary care services. This helps to ensure to the greatest extent possible that urgent care needs are met in the primary care setting.

As the Deputy knows, out-of-hours arrangements in the mid-west region are discharged through Shannon Doc, which is a not-for-profit GP co-operative funded by the HSE. Shannon Doc recently announced that due to a difficulty in attracting GPs, and in particular locum cover, it is no longer able to maintain its existing service across all its centres. Following discussions with Shannon Doc, and in order to ensure the sustainability of the service, the HSE accepted a proposal from the co-operative to change the provision of the service. The most significant changes relate to parts of east and west Clare, essentially affecting Ennistymon, Kilrush and Killaloe, with minor changes in operating hours at two locations in north Tipperary. The Government is committed to ensuring patients throughout the country continue to be able to access GP services, especially in remote rural areas and certain disadvantaged urban areas. It is also committed to ensuring general practice is sustainable in such areas into the future. It is imperative that existing GP services in these areas are retained and that general practice remains an attractive career option.

The development of primary care is central to the Government’s objective to deliver a high-quality, integrated and cost-effective health care system. There is a commitment in A Programme for a Partnership Government to a decisive shift within the health service towards primary care to deliver better care close to home in communities across the country. The programme for Government emphasises the need to focus on enhancing primary health care services by building up GP capacity, increasing the number of therapists and other health professionals in primary care and continuing to expand the development of primary care centres and facilities. The annual GP training intake has increased from 120 prior to 2010 to 172 this year. I know the Minister, Deputy Harris, is anxious to achieve further increases in future years. The Minister has emphasised the need for a new GP services contract which will help to modernise our health service and develop a strengthened primary care sector.

Health service management has made progress with a number of significant measures through engagement with GP representatives. The GP contracts review process will, among other things, seek to introduce further measures aimed at making general practice a fulfilling and rewarding career option into the future. Progress to date includes changes in the entry provisions to the GMS scheme to accommodate flexible or shared GMS-GP contracts, and an enhanced supports package for rural GPs which includes a change in the qualifying criteria for rural supports and an increase in the financial allowance from €16,216 to €20,000. The recent changes to the Shannon Doc out-of-hours service will be subject to a three-monthly review. Their impact will be closely monitored and evaluated by the HSE. I hope the Deputy finds this information helpful.

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