Pa Daly (Kerry, Sinn Fein) | Oireachtas source

I thank the Rural Independent Group for bringing forward this worthy motion. This may well be the seventh anniversary of the Committee on the Future of Healthcare's Sláintecare Report. Despite the commitment to ending the two-tier system contained within the health service, little progress has been made. This is especially the case in the context of GP care.

The Sláintecare Report states:

A new GP contract is due to be negotiated in 2017. The new contract provides an opportunity for the GPs to provide the core leadership role in delivering care outside of hospital in multidisciplinary primary care teams.

I get slightly jealous when I hear some of my colleagues from the cities talking about primary care centres because there is a big absence of them in rural areas. The report goes on to state

Potentially, GPs will be hired as salaried HSE staff in areas where it is hard to attract them. In order to extend primary care to the whole population more GPs and primary care staff are needed ...

It is obvious that in some rural areas, qualified GPs do not want to work five days a week. They do not want to work weekends, but they will work two or three days a week. Directly employing them would find a solution in order that they could go in. In recent years, I have seen, in Ballyduff, Milltown and other areas around Kerry, how it has been difficult to attract a GP who wants to sign up to the HSE contract. The lack of progress that has been made in the past seven years with regard to GP cover is disappointing. County Kerry has a high degree of rural isolation and peripherality. In that context, appropriate GP care is key. Campaigns such as the one in Clare - known as No Doctor, No Village - highlight the importance of GPs to rural communities. The most recent Sláintecare progress report up to May 2023 merely states that there is a strategic review of GP services, setting out measures to ensure that sustainable services into the future should be approved. Terms of reference have been published but little else seems to have occurred. All the time, communities suffer, and some right-wing forces have then stirred division by pointing out the lack of services in rural areas. I would like to say that there have been difficulties in the Ring of Kerry, Killarney and other areas around Kerry long before 70 people arrived at the Muckross Road. It is very divisive and irresponsible of some Deputies to raise this as an issue that is only caused by migrants.

With GP care under pressure in County Kerry, there are other solutions to salaried GPs. Pharmacists, as has already been stated, could be engaged to ensure late-night options are available across the State. I was interested to see that the NHS in England made similar suggestions so that in specific conditions, patients can be prescribed medicine by pharmacists without the need to see a doctor.

There is also a constant demand for patients to avoid accident and emergency departments. It came to my attention recently that a constituent from Ballybunion who had a heart difficulty went into an accident and emergency department. The following day, some 11 hours later, they left and went to a hospital in Dublin instead. That cannot continue. Pharmacists can be suitable for some of these functions, and it should be explored to free up GP appointments and accident and emergency departments for more urgent care. I know that the hospital in Kerry has a capital submission in to have a minor injuries clinic on the same campus but outside of the accident and emergency department, which will free that up, in addition to some other capital submissions.

I will finish on this point. The minor injuries clinicin Gurranabraher in Corkhas been very successful.

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