Dara Calleary (Mayo, Fianna Fail)
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I thank the Ceann Comhairle and his staff for allowing me to raise this issue this evening. Being a Galway man, the Minister of State is probably familiar with Kiltane and Bangor Erris, which is at the centre of the parish. There has been an excellent general practitioner serving that community for some years now. The superb staff there give a very good service. It was difficult to fill the vacancy when it arose some years ago but the GP has worked hard and built confidence with the community and he is providing a good service. We understand from the HSE that he has been offered another position in the west of Ireland and intends to take that up. As the Minister of State can imagine, members of the community are concerned that they will be left without GP services. There is an information deficit about what may happen at the end of February when the GP is due to take up the new position.

This raises the wider issue of rural GP services. I note Deputy Harty is here with us. The Minster of State did not make it out to the GP protest outside the House yesterday but he will have heard the frustrations of GPs, old and young, on resourcing. This is a broader issue which I raised during Priority Questions with the Minister for Rural and Community Development, Deputy Ring, some weeks ago. It is not right that the Department of Rural and Community Development is giving everything to try to maintain services. The Minister of State at the Department of Health has to step up to the mark as well.

We should use Bangor Erris as a case study or pilot study. I reckon the time has come for the HSE to step in and provide surgeries and facilities in the same way that IDA Ireland provides advance factories. The HSE should provide, through a public service obligation, a subsidy towards the employment and retention of staff.

One of the reasons these communities are not as big as we would wish them to be is diminishing services. If we provided support in terms of premises and a subsidy towards the running costs of GP practices in rural areas, we would attract GP services to rural communities and retain them. People would be willing to apply to provide the service. I appeal to the Minister of State to use this situation as a potential case study and to engage with HSE officials in Mayo. They are trying their best to try to resolve this issue. We need to give certainty to the people of Bangor Erris and Kiltane in respect of the long-term provision of GP services in that proud community, which needs this service. For a small investment, the Minister of State would find that we could come up with a model that might help to resolve some of our issues about providing GP services throughout the country.

I appeal to the Minster of State to go back to his Tuam and Galway roots, champion this issue at Government and work with various Departments. Let us try to do this and keep the current doctor in Kiltane and Bangor Erris. Let us allow him to provide the kind of service that he wants to provide to those in a community who trust him greatly.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Dara Calleary for raising this important issue. I assure the Deputy that I always go back to my Tuam and Galway roots. I also assure the House that the Government is committed to enhancing primary care services, including general practice services. This is central to the Government objective of delivering a high-quality, integrated and cost-effective health service. Our goal is to ensure that patients throughout the country continue to have access to GP services, and that general practice is sustainable in all areas into the future. It is imperative that existing GP services are retained and that the new general practice remains an attractive career option for newly qualified general practitioners.

The number of GPs on the Medical Council specialist register continues to increase. They have increased from 2,270 in 2010 to 3,723 as of 1 January 2019. The number of GPs holding General Medical Services, GMS, contracts has also risen from 2,098 in 2008 to almost 2,500 in 2019.

The Government is aware of workforce issues facing general practice, including the influence of demographic factors. In recent years, the Government has implemented a number of measures to improve recruitment and retention in general practice. GP training places have been increased from 120 in 2009 to 202 in 2019, an increase of almost 70% over this ten-year period. As stated in the programme for Government, the intention is to continue to achieve annual increases in the number of training places available.

Entry provisions to the GMS scheme have been changed to accommodate more flexible GMS contracts. The retirement age for GPs has been extended to 72 years. An enhanced support package for rural practices has been introduced with improved qualifying criteria and an increased financial allowance of €20,000 per annum. The Government is also committed to engaging with GP representatives on the development of modernised GP contractual arrangements - one of the points raised by Deputy Calleary.

A talks process is underway between the Department of Health, the HSE and the IMO. Discussions are ongoing in an effort to bring matters to a conclusion. Agreement on the delivery on a range of service improvements and contractual reforms has the potential to facilitate a substantial increase in the resourcing of general practice on a multiannual basis. The HSE is fully committed to ensuring GP services continue to be provided to people in Bangor Erris, County Mayo. The HSE has confirmed that it will immediately advertise the GMS panel concerned and will explore all options available to ensure GP services continue to be provided in the area into the future.

The current GP will continue to provide services until the end of March. The HSE will ensure locum arrangements are in place following this to ensure patients continue to have access to a GP service, pending the appointment of a GP to take over the panel permanently.

Dara Calleary (Mayo, Fianna Fail)
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I welcome the clarification in relation to Bangor Erris. However, the Minister of State's response is completely removed from the reality on the ground. He spoke of increased places on GP training schemes. For the first time anyone can remember, there are vacancies on training schemes because people do not want to be GPs. It is no longer a desired option for so many people and those who do, do not want to be a GP in Ireland. GP practices are no longer viable in many areas, which the Minister of State would have heard yesterday. I know that there are communication difficulties in the Department of Health but surely the Minister of State must have heard the complaints. We hear this from younger doctors but one of the most disheartening things yesterday was to hear older doctors who have put their life and soul into building up practices and communities, now more or less broken and not recommending that people follow their path.

When this contract was last advertised it was difficult to fill because of the lack of supports. The Minister of State referred to the rural practice allowance, but it is not enough. We must look at this differently. By the time a premises is kitted out and staffed, €20,000 does not go far on a list of 500 people.

This must be looked at differently. This will have to be used as a pilot to put the facilities and services for GPs in place and give them an investment. Then we will fill the vacancies. There are vacancies in rural areas that cannot be filled, yet the Minister of State spoke of the numbers of GPs on the register increasing. That is no good to someone who cannot access a doctor because there is no doctor in his or her community.

Once again, I ask that the Government put together a package, using Bangor Erris as a pilot, to put the facilities in place and work with the existing GP. It might find that he is more than happy to stay there. I can assure the Minister of State that the community has enormous trust in both him and his staff and they want to keep him there.

Finian McGrath (Dublin Bay North, Independent)
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I did hear the GPs yesterday and I meet GPs regularly. I am aware of the genuine issues that the Deputy raises.

I wish to reiterate the Government's commitment to ensure that patients throughout the country continue to have access to quality GP services. The Department of Health, together with the HSE and the Irish College of General Practitioners, are committed to working together to improve recruitment and retention in general practice in coming years.

I will put the Deputy's two proposals on the pilot study and working with GPs to the Minister, Deputy Harris.

The goal of the current phase of the GP contract talks is to reform and modernise the existing GMS contract. This will be key in making general practice a more attractive career to young doctors.

In the case of GP services in Bangor Erris, I wish to reassure the Deputy that the HSE is taking all necessary steps to ensure that a new GP is recruited as soon as possible and that the locum arrangements will be in place to ensure services to this community are retained while the recruitment process is underway.