Jackie Cahill (Tipperary, Fianna Fail) | Oireachtas source

I thank the Ceann Comhairle for selecting this Topical Issue. It is a significant issue throughout Ireland and is a particular problem in Tipperary over the past 12 to 18 months. We have failed to attract young doctors into practices, even practices that appear on the surface to be very attractive. We must tackle this problem immediately.

Some 27% of doctors in County Tipperary will retire in the next seven years. This problem must be approached on a number of fronts. One of them is finance for primary care. There is not enough investment in primary care. A study was carried out in a practice in Longford recently where proper primary care was being provided for diabetes patients. This reduced complications by 80%. The saving this generated in avoiding expensive secondary care is enormous. Primary care needs more nurses, physiotherapists and occupational therapists. If resources were put into primary care, the savings down the line would be immense.

The quality of life must be addressed to attract young doctors into general practice. We expect doctors, particularly those in single practices, to work extremely long hours. They have alternative options in Canada and New Zealand that are far more attractive. If we are serious about this, we must change their terms and conditions. New contracts and a new pay structure must be put in place. There must be investment incentives for rural doctors to upgrade their premises. Rural practices are not part of a primary care centre so if tax breaks were put in place to incentivise doctors to invest in their practices it would be a great help. Many local practitioners feel frustrated that they do not have the wherewithal to invest in their practices. The FEMPI legislation implemented huge cuts, including a severe cut to the rural practice allowance. That must be restored and increased to approximately €25,000. The travel allowance, or distance code, had a huge effect on primary care in rural areas.

All these issues must be addressed if young doctors are to be willing to take up the challenge of serving in these practices.

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