Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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I welcome the Minister of State. I appreciate him turning up to take this matter. A week ago, the people of Blarney and the surrounding area woke up to the news that their local GP is to resign at the end of this year. At a time when we know how difficult it is to get access to a GP, this has sent a shock through the community. This decision affects 1,600 patients, 600 of whom are public and 1,000 private, between medical cardholders and private patients. On hearing the news, I wrote to and contacted the HSE, as did a number of my constituency colleagues. We were assured by the HSE that the public patients will be looked after by an interim service within 8 km of Blarney for the foreseeable future, until such time as a new doctor is recruited. This is welcome and very much appreciated.

I understand that one GP has already indicated interest in taking up the service and a number of other parties are also keen to express interest. I have taken the opportunity to write to all GPs within a 10 km radius of Blarney encouraging them to do all they can in helping in the interim and, in particular, to look after those 1,000 patients who do not have a service in the meantime. Despite all the usual scaremongering and politicisation of the issue locally, I seek some reassurance from the Minister of State that what the HSE tells me is true, that an interim arrangement has been made, and that the process of the advertisement of the post is being readied. If he could give any other pertinent details, it would be very much appreciated.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Deputy for raising this important issue. As he is aware, GPs are private practitioners, although most hold contracts with the HSE to provide services under various health schemes. There are currently more than 2,500 GPs with General Medical Services, GMS, contracts for the provision of GP services without charge to medical card and GP visit cardholders. As they are private practitioners, GPs are free to establish their practices and work at a location of their own choosing. However, where a GP vacancy arises in a practice with a GMS contract, the HSE becomes involved in the recruitment of a replacement GP. At the start of November, there were 27 GP GMS vacancies, approximately 1% of the GMS GP panels. Some 13 of the 27 vacancies were in rural areas and 14 were in urban areas.

On the expected GMS vacancy concerned, Cork Kerry Community Healthcare has advised that it is aware of the upcoming vacancy and is taking appropriate steps. Engagement is ongoing with local providers and an interim service is being planned to ensure continuity of services for the cardholders concerned from 1 January, while the campaign to recruit a replacement GP is ongoing. Once interim arrangements are finalised, the HSE will contact cardholders to inform them of the particulars of this arrangement. The HSE will contact cardholders again when a replacement GP is in place.

The Government recognises the high demand for GP services and has taken measures to make working in general practice in Ireland more attractive. This will improve the recruitment and retention of GPs, increasing the number of GPs throughout the country. The rate of remuneration under the GMS scheme has been increased with additional annual investment of more than €200 million being provided under the 2019 GP agreement. For GPs, this means increased capitation rates, increased rural practice supports, and increased contributions to leave arrangements. Furthermore, budget 2023 provides for additional funding for practice supports in advance of the expansion of GP visit card eligibility from next April for those who earn the median household income of €46,000 or less. Specifically on rural practices, the agreement provides for a 10% increase in payments under the pre-existing rural practice support framework and a 28% increase in dispensing doctors' fees. Practices that receive rural practice supports attract the maximum allowable rate per practice to support subsidies and local contributions for leave taking.

The number of doctors entering GP training has more than doubled in recent years from 120 in 2009 to 258 in 2022, with 350 training places planned to be available by 2026. This shows that the measures undertaken are having an impact and will increase the number of GPs working in the State. A strategic review of GP services is due to commence shortly and is to be completed in a relatively short timeframe. This review, with input from key stakeholders, will examine issues affecting general practice, including issues around rural GP vacancies, and will set out measures to improve provision of GP services.

Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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I appreciate the response. I have much of that detail already from the HSE locally through community healthcare organisation, CHO, 4. The real reason I am here is that many elderly people are fairly distressed and fearful of losing their service. I am glad to hear the Minister of State assure the House that the HSE has taken interim steps. I am aware that a GP has been located locally to step in and fill the breach until such time as a new GP is appointed. All that is welcome but, unfortunately, that is not what is being filtered out through local media at present. There is scaremongering and politicisation of this matter. That is wrong, especially, as I said, when we have elderly people who are severely distressed and might be concerned about future appointments, or prescriptions to be made out or whatever. It is wrong on the part of those people who are trying to politicise this.

I understand that a letter is to be sent this week to all patients affected detailing those interim arrangements. That will, it is to be hoped, at least reassure many of them that the HSE is doing all it can to fill this void. As already stated, it is unfortunate that private patients are in a situation where they face the prospect of having no GP over the Christmas period but I understand that a number of nearby GPs are already taking those patients on as well. I encourage anybody who is concerned to either get in touch with me or with other GPs in the vicinity, who are helping out where they can.

The Irish College of General Practitioners, ICGP, is due to announce a scheme for the recruitment of non-EU GPs in the coming weeks. Thankfully, this is being supported by the HSE. Some 20 GPs for rural areas will be employed in the first tranche. A second tranche of GPs is already being lined up for CHO 4. This is being done as part of a pilot programme by the ICGP. More details about that will follow in the next few weeks.

I am happy with the Minister of State's response. It reassures me. I hope it will also reassure people in my constituency that there is a process in place. We should be helping to ensure that process is followed rather than trying to undermine it.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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The HSE is aware of the expected retirement of the GP concerned and is taking appropriate steps to arrange for the continued provision of GP services for affected cardholders until such time as a replacement GP is in place. The HSE's focus is on ensuring continuity of care. It is currently engaging with local providers to implement a plan for services in the interim. As the Deputy stated, we need to take steps to reassure people. Sometimes, the wrong message can go out. It can be difficult to get the right message out there. As the Deputy also indicated, the HSE will contact affected medical cardholders and GP visit cardholders to advise them when these arrangements are finalised. It will also contact them when the new permanent GP is in place.

There is an increasing demand for GP services. Significant measures have been taken to increase the number of GPs working across the country. There are positive signs, including the increase in the number of doctors entering GP training as well as an increase in the number of GPs on the specialist register, that access to GPs will improve. The issues affecting rural GP practices and the difficulty in filling rural GMS vacancies will be examined as part of the upcoming strategic review of GP services. This review will set out further measures to improve the delivery of GP services.

The Deputy mentioned that the ICGP will be bringing in some non-EU GPs. That is another step in the right direction. It may allow us to address this issue. As already stated, sometimes the wrong message can go out and it can be difficult to get a positive message out to people. However, what I am seeing is quite positive in the context of dealing with and trying to resolve the situation that has arisen. I again thank Deputy O'Sullivan for his co-operation and for his interest in this important issue.