Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this issue. The provision of out-of-hours GP care is a fundamental component of general practice and appropriate access to GP out-of-hours services must be maintained.

Under the general medical services scheme, contracted general practitioners must make suitable arrangements to enable contact to be made with them, or a locum or deputy, for emergencies outside normal practice hours. Most choose to participate in GP out-of-hours co-operatives or other GP out-of-hours service providers to meet this contractual requirement. These services have developed and expanded over time and are now an essential part of our primary care services. Access to GP care outside of usual practice hours is necessary to ensure, to the greatest extent possible, that urgent care needs are met in the community rather than in an acute care setting.

The NowDoc out-of-hours service provides urgent GP care to patients of County Donegal and south Leitrim. As the Deputy will be aware, while GP out-of-hours services are largely provided by private co-operatives, the NowDoc service is run and managed by the HSE in partnership with Caredoc, which provides GPs for the delivery of care.

The HSE community healthcare organisation, CHO, for the region concerned has advised that it has entered exploratory discussions with relevant stakeholders to examine the most effective arrangements needed to continue to deliver a safe, quality-driven service for County Donegal and south Leitrim. This examination of the service forms part of the HSE response to significant clinical concerns raised by the Caredoc GP board members.

The HSE has given assurance that no decision has been made on the redesign of the operating model for those areas, and no decision will be made without the active involvement of relevant stakeholders. The HSE will continue to communicate and engage with all relevant stakeholders to ensure they are fully consulted regarding any future developments.

The HSE CHO has confirmed that there are currently no plans to move the treatment centre from Carrick-on-Shannon or change the level of services provided there. It should be noted that the GP out-of-hours service for Sligo and Leitrim is managed as a singular model of service through a service level agreement with Caredoc. As this model is operating effectively, it is not included in the current examination under way.

Regarding out-of-hours services in general and across the country, the HSE engages regularly with all service providers and provides significant supports towards service delivery. The out-of-hours support grant that has been in place since 2020 was increased this winter. Additional temporary funding has also been provided to out-of-hours service providers to allow the rostering of more doctors in treatment centres between the hours of 6 p.m. and 10 p.m. This allows for more patients to be seen over this busy winter period and helps reduce the need for emergency department attendance.

Service quality and patient safety in the delivery of out-of-hours GP care remain paramount for the HSE, and direct its decision making on the provision of services by providers including NowDoc.

See this speech in context