Catherine Byrne (Dublin South Central, Fine Gael) | Oireachtas source

I thank the Deputy for raising this issue. At the outset I would like to assure the House that the Government is committed to enhancing primary health care services, including GP services. The development of primary care is central to the Government’s objective to deliver a high quality, integrated and cost-effective health service and to reduce the numbers coming into hospitals. The goal is to deliver better care close to home in communities across the country and move away from a system which is too dependent on hospital care. In a fully developed primary care system, 90% to 95% of people’s day-to-day health and social care needs can be met in the primary care setting. The winter period is one where particular pressures occur in the health service. For this reason the Minister for Health ensured that considerable planning was undertaken by the HSE ahead of the peak period. A sum of €40 million was provided to assist in the management of winter pressures and to manage the expected winter surge in demand for hospital care in an integrated way across primary, acute and social care. As part of the winter initiative, South Tipperary General Hospital has been identified as one of the nine focus sites experiencing the greatest challenges in terms of ED pressures. Consequently, under the initiative additional measures have been put in place to support the hospital in responding to surges in demand for emergency care over the busy winter period. These include actions to improve early discharging; increase access to community intervention teams, CITs; and increase access to diagnostics. The winter initiative has allowed for the provision of three additional home care packages per week at the hospital until the end of February 2017.

The winter initiative also recognises that there are specific challenges in relation to capacity at the hospital. The HSE is working towards providing extra surge capacity through the fit out of additional space on the first floor of the hospital to alleviate pressure on the ED. This extra capacity is expected to be available from early May and could be used to accommodate space for up to 11 beds. I acknowledge, on my behalf and that of the Minister for Health, the tremendous contribution of all the front-line staff to meeting the heavy demand on our health service during the peak winter period, both in our hospitals and in our communities. The management by GPs of seasonal pressures, which include many patients presenting with exacerbations of chronic conditions, is an example of how primary care plays a critical role in our health care system. In fact, our GPs were at work over the Christmas and New Year period dealing with a substantial workload while many other people were able to enjoy a few extra days off.

It is important to recognise the commitment of GPs to ensuring a responsive, accessible and high quality service to patients on a year-round basis. Recent data from the HSE indicate that in 2016 there was an increase of around 5% in emergency department attendances nationally. In addition, early January 2017 saw continued significant pressure on our EDs due to high demand, increased incidence of flu and respiratory illnesses across the country, which have been disproportionately affecting at-risk groups such as the elderly, as well as ongoing bed capacity restraints due to staff shortages.

GP out-of-hours services also experienced large volumes of patients in attendance. I understand that the number of contacts with these services increased by 13% in December compared to the previous month. In fact, there were over one million contacts with GP out-of-hours services in 2016, an 11% increase over 2015. The Government is committed to the continued development of GP capacity and in 2017 the training intake will increase for the second successive year, from 172 to 187 places. Further efforts undertaken in recent years to increase the number of practising GPs include changes to the entry and retirement provisions for GPs under the OMS scheme, as well as the introduction of an enhanced supports package for rural GP practices.

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