Brian Stanley (Laois, Independent)

I raise the problem people around the State have in accessing a GP or getting a GP to take them on. It is even more difficult for people who do not have a medical card. It is a huge problem. There is a shortage of locum doctors, which leads to problems for some GPs trying to take holidays or leave. The emergency departments of hospitals are clogged up with people who should be seen in a community care or primary care setting. Some go to emergency departments either because they cannot get a GP appointment or do not have a medical card and cannot afford a GP visit.

A recent Economic and Social Research, ESRI, report outlined that we need between 943 and 1,211 to cope with demand. That is just to stand still, not to improve the ratio of GPs per head of population. We know from several sources that the number of GPs per head of population is way too low and is completely out of sync with our European neighbours and other developed countries.

The Irish College of General Practitioners has stated that we have a huge deficit. It has identified several counties that have a chronic shortage, including County Laois. The Irish Medical Organisation, IMO, concurs and has highlighted this fact as well. The State has only 60% of the GPs per head of population that Germany and other EU states have. Some EU states are even more favourable than that. The IMO reckons one GP per 900 people is required to provide adequate community care. The World Health Organization says it is one per 1,000 population.

In County Laois, the ratio is, on average, one GP per 1,600 population. Only 35 GPs out of 67 in the county take medical cards. At least 700 GPs are to retire between the years 2023 and 2026. There are not enough new GPs in training and in many cases, when they qualify they are faced with a choice of trying to establish a general practice or emigrating. Some emigrate because of the cost of trying to establish a practice, pay for premises, hire equipment, hire staff, etc., and the long hours. We have a chronic shortage due to the lack of forward planning by all Governments over the previous 20 years. Solutions are needed now.

We need a major ramp-up of directly employed, salaried GPs working in general practice. Last week, the Tánaiste said here he is favour of this as well. Many of those trained GPs would be more likely to remain if they could work in a 35 to 40 hour week job, particularly a lot of women who are coming into it - more women are coming in and that is welcome - because, unfortunately, they tend to have more home and caring responsibilities. As a society, we have more work to do in that area. The number of training places needs to be increased substantially. When young GPs qualify, the HSE needs to actively recruit them and offer them permanent positions.

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