Thomas Gould (Cork North Central, Sinn Fein)
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Blarney GP service closed on 31 December when the GP retired. The service was closed and patients were sent to different areas. They were sent to Ballincollig, Blackpool and Ovens. There was a process under way to appoint a new GP. An announcement came last week and patients were told they would have to travel to Blackpool. There are vulnerable patients, including people with lifelong illnesses, families, and now they are expected to travel from Blarney to Blackpool. The people of Blarney are really upset by this. The HSE should have moved earlier. It was not until I contacted the HSE last year to let them know that the doctor was retiring that the position was advertised. It is not good enough from the HSE to leave advertising GP services to the last minute. It is really disappointing for the residents. To follow on from that, a GP is now retiring in the St. Mary's primary care centre in Gurranabraher. The same thing has happened again. This GP wanted to do a handover with a GP who is also in the primary care centre so that his patients would have the best possible handover and treatment.

The HSE, however, did nothing for months. The doctor did everything in his power to plan for the goodwill of his patients but, once again, the HSE has procedures in place that I do not understand. When it knows a GP is leaving, the position should be advertised immediately. In addition, GP services should be kept locally. There will now be an interim GP service even though there is a GP based right next to the practice from which the GP is leaving. It does not make sense. Patients are losing out again.

The HSE must take responsibility. This affects vulnerable patients. It is really disappointing. People in Blarney have made the point that Blarney is a village but it is growing. It has a huge hinterland. Patients are now travelling all over Cork North Central to get the GP service they need. It is not good enough. I want the HSE to change its procedures and get the GP service back on St. Mary's campus in Gurranabraher and the people of Blarney to get their GP services back in Blarney rather than being expected to travel. Even if a GP was put back into Blarney, there is a significant backlog for GP services. We need the primary healthcare service that was promised for Blarney.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this issue, which I am taking on behalf of the Minister, Deputy Stephen Donnelly. As the Deputy will be aware, GPs are private practitioners, although most GPs hold contracts with the HSE to provide services under public health schemes. There are currently 2,539 GPs with a general medical services, GMS, contract for the provision of GP services without charge to medical card and GP visit card holders. As they are private practitioners, GPs are free to establish their practice and work at a location of their own choosing. However, when a GP vacancy arises in a practice with a GMS contract, the HSE becomes involved in the recruitment of a replacement GP. Obviously, we wish both doctors who have served the people of Blarney and the surrounding area for many years all the best in their retirement.

The HSE recently undertook a recruitment campaign for the GMS vacancy in Blarney and several candidates were interviewed in late February and early March. A GP has been identified through this process and is anticipated to take up the position of the GMS GP for the GMS panel on 1 July 2023. Regrettably however, as the Deputy stated, it has not been possible to arrange for the GMS GP service to be based in Blarney. The GMS GP service will be located in Blackpool, which has strong transport links to Blarney. Correspondence was issued to the main cardholders of this GMS panel on Thursday, 13 April. The HSE appreciates, as do I, as Minister of State with responsibility for older people, that this relocation will present a challenge for some GMS cardholders and, accordingly, a change of doctor process will be available from 1 July to those who require it.

As regards the expected GMS vacancy at St. Mary’s primary care centre, the HSE has advised that it is aware of the upcoming vacancy and will advertise the GMS panel on 1 May. Engagement is ongoing to provide cover for the GMS panel on an interim basis to ensure continuity of services for the cardholders concerned.

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 over €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. Specific to rural practices, the agreement provides for a 10% increase in payments under the pre-existing rural practice support framework and a 28% increase to dispensing doctor fees. Practices that receive rural practice supports attract the maximum allowable rates for practice staff support subsidies and locum contributions for leave taking. The terms of reference for a strategic review of general practice have recently been published. This review will commence shortly and will be completed this year. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice and will set out the measures necessary to deliver a more sustainable general practice.

To sum up, the HSE steps in where a GP is retiring. It has tried everything to recruit and it has managed to recruit a doctor for the original GP service in Blarney but, unfortunately, that will be located in Blackpool in the short term. It will be recruiting for the St. Mary's primary care centre starting on 1 May.

Thomas Gould (Cork North Central, Sinn Fein)
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I thank the Minister of State. I thank Dr. Gibson, who is retiring from St. Mary's campus, and Dr. O'Halloran, who retired at the start of the year. Unfortunately, the response provided by the Minister of State gives very little hope for the people of Blarney or for those who attend St. Mary's campus. There is a severe lack of GP services in my constituency. People regularly contact me because they cannot get a GP, while those who have a GP are struggling to get appointments because GPs are overwhelmed. There are six primary care centres in Cork city but there is only one in my constituency of Cork North-Central. Some 131,341 people live in my constituency but there is only one primary care centre. That is completely unfair to the staff, the people of the area and the communities in which they live. Areas such as Blarney, Glanmire, Bishopstown, Ballyvolane, Mayfield and the Glen do not have primary care centres.

In Fine Gael's election manifesto, it promised 90 primary care centres. The Fine Gael spokesperson on health is based in my constituency but we have not seen a single primary care centre opened or even announced. Fine Gael promised to deliver primary care centres but that has not happened. The centre in Blarney has a planning issue but what contingency plan was there to deliver another such centre in the town? I spoke to Dr. O'Halloran, who was working in Blarney. She retired because the primary care centre was not delivered and she could not get the HSE to support her with holidays or if she was sick. The Minister of State made the point that GPs are private practitioners. They need support, however, because many of them cannot keep going on their own. She referred to the challenges and stated that the HSE will advertise Dr. Gibson's GP service on 1 May. Months ago, Dr. Gibson told the HSE he was leaving. I contacted the HSE weeks ago, asking it to advertise the position so that the GP service could be kept there. Why is the HSE being evasive and not advertising the positions? Why is it not being proactive? Is there an alternative reason for this? We need local GP services in Blarney and on the St. Mary's campus in Gurranabraher.

Mary Butler (Waterford, Fianna Fail)
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I do not have a response in respect of primary care centres at the moment but I know the Minister, Deputy Stephen Donnelly, was in counties Sligo and Donegal last Friday to open three primary care centres. Nine primary care centres were announced in December last year. We have been building primary care centres for the past five or six years and rolling out eight or nine of them each year. I was delighted to announce one for Lismore in County Waterford a couple of weeks ago. I will check the latest details in respect of the proposed primary care centre in Blarney.

The HSE has undertaken a recruitment campaign for the GMS vacancy in Blarney and a GP has been identified through the process and is anticipated to take up the position of the GMS GP for the panel on 1 July. The HSE has issued correspondence to the affected main cardholders of the GMS panel. They were informed on Thursday, 13 April. They will have the opportunity to change after 1 July. The HSE is aware of the expected GP retirement at St. Mary's primary care centre and is taking steps to ensure the provision of GP services for affected cardholders until a replacement GP is in place. It is attempting to get a GP but we all know there are a lot of difficulties in that respect at the moment. The Deputy referred to Dr. Gibson and Dr. O'Halloran, who have probably served the area for many years. People are always upset when their GP leaves. The HSE is doing everything it can to provide alternative cover in the short term. Nowadays, many doctors do not want to take over a full practice whereas they might work in a practice that has several doctors.

I will raise the Deputy's concerns with the HSE tomorrow.

Thomas Gould (Cork North Central, Sinn Fein)
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I thank the Minister of State.