Ann Phelan (Carlow-Kilkenny, Labour) | Oireachtas source

I thank Senator Whelan. I am taking this Commencement debate on behalf of the Minister. Senator Whelan raises an important issue. Given my role as Minister of State with responsibly for rural affairs, I can see why there are grave concerns in rural parts of Ireland where these situations may arise. The HSE is committed to the provision of high-quality general practitioner services through the general medical services, GMS, contract for GPs. GMS GP posts are filled in line with HSE human resources recruitment guidelines. Periodically, challenges can be experienced in respect of the permanent filling of GP posts. In areas where this challenge is experienced, every effort is made by the local HSE management to ensure the provision of GP services to all GMS patients.

The retiring doctor in Borris-in-Ossory advised the HSE of his intention to resign from the GMS scheme in November 2014. The GP practice is a single-handed rural practice with a GMS panel of approximately 830 patients. The GMS panel was advertised by open competition and interviews took place in late 2014. Two people applied, and both were placed on the panel following a successful interview. Both successful candidates, however, declined the offer of the position. The position was subsequently re-advertised by open competition in early February 2015.Interviews took place in the first week of March 2015. The HSE has engaged systematically with two successful candidates based on their panel position and I am happy to state that the first placed candidate has accepted the position and will commence work as soon as possible, something I know the Senator will welcome.

While GP numbers are keeping pace with overall demographics, this does not always prevent shortages occurring at local level. GPs once qualified, tend to work for existing GP practices or as self-employed contractors and are free to decide where to establish their practices. Isolated rural areas and deprived urban areas, very often with limited private practice opportunities, may sometimes find it difficult to attract GPs to fill vacant posts, a point the Senator mentioned.

The HSE is actively seeking to address this issue with medical organisations with a view to developing practical measures, including reorganising lists with existing doctors in local areas and through the adoption of a more flexible contractual arrangement which would encourage young GPs to work in such areas. The Department of Health and the HSE are currently in discussions with the IMO about the introduction of flexible or shared GMS contracts. The possibility of extending the current GMS GP retirement age from 70 to 72 years of age is also being considered.

The introduction of shared GMS contracts would provide more family friendly working arrangements better suited to the increasing number of female GPs, thus making it more attractive to pursue working within the GMS. Under the programme for Government, it is intended to develop a new contractual framework for GPs which will be more suited to current needs and will facilitate the planned development of primary care services. Substantive discussions on a new GMS contract will commence shortly with the IMO. Mechanisms for encouraging GPs to set up practices in rural and urban disadvantaged areas will be considered, as appropriate, in the context of these discussions. In the meantime, where GMS GP vacancies arise in an area, the HSE will take the necessary steps to ensure that continuity of service to GMS patients is maintained.