Jackie Cahill (Tipperary, Fianna Fail) | Oireachtas source

I thank the Ceann Comhairle's office for selecting this Topical Issue. The availability of GPs in rural and urban areas is becoming a huge issue in my county. At this stage, five or six positions are being left vacant because there are no applicants. Unless this situation is addressed fairly rapidly it will become a crisis for our communities. In recent months, an urban practice in my town has advertised a vacancy through the HSE three times, but no applicant has come forward for the position. The situation is grave and we must act now to avoid a crisis. We must attract young graduates to GP practices. Unfortunately at present this is not happening. Young graduates are deciding to emigrate, leaving us with a scarcity of doctors entering the system.

When FEMPI was introduced during the financial crisis doctors were hit more than most as 38% was taken from the fees they charged. Taking into account the salaries paid to nurses and other staff in GP practices, they suffered a 45% cut on what they receive from the HSE. This must be reversed and improvements must be made in the payment structure. With regard to the pensions received by doctors, they qualify for €17,000 under the GMS pension. This is a very small pension and it must be examined. It pales in comparison to what is available to managers in the HSE.

There has been a focus on building primary care centres but the reality is that most GPs in rural areas and small urban towns have their own facilities. Pouring money into primary care centres if we do not have GPs available is like putting the cart before the horse. I appeal to the HSE to examine each area before it builds primary care centres. Doctors with their own facilities should be allowed to use them and the extra resources should be put into trying to attract young doctors into rural areas.

Another anomaly is that doctors in a county such as mine must pay for 24-7 cover. They must contribute quite significantly to services such as Shannondoc.

In large urban areas, however, there is no charge on GPs for 24-7 cover. This is an anomaly that needs to be addressed urgently.

Training places need to be increased because there are not enough for GPs at the moment. When GPs graduate it should be mandatory for them to spend a number of years working in this country. We have a very sought after education system for medical doctors but when they qualify a lot of them head to other shores to practise and the country gets no benefit from the investment that has been put in.

Locums are another huge issue for rural practices. The tax treatment of locums has to be looked because it is virtually impossible for a rural practitioner to get a locum to help him out in his practice. One can expect no man or woman to work 365 days a year so it should be made attractive for locums to work in rural and small urban practice.

Community care teams have to be properly funded as these can take a good bit of pressure off local GPs, whether it is through the physio calling to a person's house or community care teams calling to dress a person's wound.

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