Michael Healy-Rae (Kerry, Independent) | Oireachtas source

I, too, pay my sincere sympathies to Deputy Michael Collins, his brother, Councillor Danny Collins, and to the mum, Kay Lynch, of the late Michael John Lynch, who would be a nephew of our colleague in the Rural Independent Group, Michael Collins. We are sorry for his sad passing. To his friends, his family and his neighbours in the Durrus area in Cork, I send my heartfelt sympathies.

I thank the leader of our group, Deputy Mattie McGrath, and his excellent staff, including Brian Ó Domhnaill, Triona and others, for their work in putting together this important Private Member's motion. I remind the House what we are actually looking for. We are saying that healthcare general practice is the patient's first point of contact with health services. It provides person-centred and comprehensive care from the beginning to the end of life, often co-ordinating care between many agencies involved in the treatment of complex chronic illnesses. General practice in Ireland, providing professional, quality care at the heart of the local community, is the cornerstone of the Irish health service, with general practitioners being the first port of call for patients. Over two thirds of GPs, 66%, in rural Ireland are currently unable to take on new patients, with some reporting waiting times of up to two weeks for an appointment according to a survey by the Irish Independent. I acknowledge and thank theIrish Independentfor the work it has done in recently reporting this serious situation, as did the Irish Examiner.

The Irish Medical Organisation warned that Ireland having only seven GPs per 10,000 population, one of the lowest levels in the European Union, falls well below the required minimum of 12 per 10,000 to ensure a safe and effective healthcare service. I want to highlight this and remind the Minister of State of those words about 12 GPs per 10,000 persons. I want to explain exactly where the Iveragh Peninsula is. I have been saying it here now for many years but I will say it again because it is where I started out on Kerry County Council.

I am talking about going from Killorglin, on through Glenbeigh and heading over Mountain Stage, down into Portmagee, Kells, Cahersiveen and Foilmore, over the water and down to Valentia Island, Ballinskelligs, the Glen in Emlaghmore, Waterville and up to Dromod, then out to Coomakista, Caherdaniel and Castlecove. When you are talking about the Iveragh Peninsula, that is where you are talking about. It is open terrain, with places that are very far from care centres of excellence. It is very far away from University Hospital Kerry, Limerick hospital or CUH, and if it were not for the advent of air ambulances in recent times, many deaths would not have been avoided.

I thank the people working in healthcare there over the years, but in the past, we had up to six GPs. Now, we are down to three, with another GP retiring. Our indigenous population in the Iveragh Peninsula was 7,000 but we have now gone over 8,000 because Ukrainian families are living there. Look at how far short of the recommended safe numbers we are. If we go down to two or three GPs, that will be for 8,000 people but, at the same time, the statistics tell us it should be 12 GPs for 10,000 people. My goodness, the people in the Iveragh Peninsula and elsewhere in south Kerry are having their lives put in danger because of the lack of GPs. I thank every one of them I know personally going back over 25 years working politically in that area. I know the GPs and the excellent service they have given. I know about the late nights, the weekends and the full cover they have given and I thank them for it. Of course, some of them have gone to their eternal reward, while more have retired or are going to retire, which they are entitled to do.

In recent times, I met the local coiste and I have been talking to the Minister for Health. I publicly thank him for the hearing he is giving me with regard to the Iveragh Peninsula. We are looking for a bespoke arrangement to be put in place because we are finding it so difficult to attract doctors there. Between providing the premises, the insurance and the backup staff and what they will earn, it is not financially viable for them. One shoe does not fit all sizes, so we desperately need a bespoke arrangement for the Iveragh Peninsula. I acknowledge the work of the Minister, which I discussed with him only in the past ten days. I want the people of the Iveragh Peninsula to know I am working on that. I am working to ensure we will have full cover with SouthDoc, which we did not have previously because we were missing Tuesday and Thursday nights when we did not have full cover. To the people who have come to me with horror stories, including over Christmas when a young boy's life was put in danger because there was no service at the time and the child had to be moved out of south Kerry late at night, I want them to know I am giving it the attention it needs.

There is an urban-rural divide in healthcare access and it has stark implications, with rural patients facing significant barriers to timely medical care despite rural areas having an older population compared with urban centres. The cumulative effect of the lack of access to GPs in rural Ireland has led to an alarming rural health crisis, which is made a lot worse by limited or absent public transport services, making the healthcare service less accessible to rural people. An Irish Independentstudy found that, on average, patients in Dublin can be easily seen on the same day as a request for an appointment, while those in the midlands or other places looking to book a non-urgent appointment with their GP could have to wait for up to two weeks.

Coming back to the issue in Kerry, if we do not have GPs working in rural Kerry, whether that is south, north, east, mid or west Kerry, and if we do not have easy access to a GP, patients are going to go to the emergency department. I thank the excellent people working in Kerry University Hospital, in particular in the emergency department because they work in very stressful circumstances. Even so, an elderly person could have to wait 14 hours to see a doctor. I have said previously in the Chamber, and I will reiterate, that if an animal needs care, there is no way in the world that its owner should be waiting for more than two hours for a vet to come to their yard. In Kerry, if you ring Padraig Teahan, Mike the vet or any of the other local vets we have, they will be into your yard within two hours to look after a calf that is in trouble after calving, a ewe lambing or whatever the difficulty is. If there is speedier access to treatment for animals than for people, something has gone radically wrong.

We have never spent more money than we are now spending on healthcare. The spend per head of our population is frightening, yet we have not got it right. We are talking about the pressure our emergency department is under. For goodness’ sake, is it any wonder? If you cannot get a GP, whether it is for a child or a middle-aged or older person who needs care, you are going to put them into the car, ring for an ambulance, land in the emergency department and take up more space there, and the case might not need to be in a hospital at all. The accident and emergency department is what it says - it is for accidents and emergencies - but in many cases it is being used for something it should not be used for.

When I was growing up in the parish of Kilgarvan, where I am from, we had an excellent doctor, Dr. Boland, who was our local doctor. Like many other parishes, we all had a local doctor. They were busy people, they were kept going and they were able to make a living. Why is it that we have gone so far from that? We are trying to attract foreign doctors and I am so grateful we have foreign doctors working in our hospitals, but we have not been able to make it profitable for a doctor coming in from abroad who is weighing up whether to become a GP in a local community or to work in the local hospital. They will want to work in the local hospital, because they know they will get a wage there and they can see where they will be able to survive and so on. If they have to go to a rural area, however, they will have to provide a house for themselves, provide a premises for the business and the surgery to be run from, sort out the back-up staff and work maybe seven days and nights a week or at least be on call. Why can we not make it profitable for those people? If it were profitable in the past and made sense in the past, why can we not go back to that system whereby in every community, you should not be far from a doctor? You are not far from a vet, but why is it easier to access the care of a vet than it is to access the care of a GP?

On that note, I thank the excellent GPs in County Kerry, who have given us Trojan service. One man I have to mention is Dr. Gary Stack in Killarney. I thank him and his team for the work they do in SouthDoc, and all the other GPs and their back-up staff throughout Kerry for their excellent care. They are working in difficult and tough circumstances. This is not to be critical of them but of us as politicians. Why are we not getting it right?

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