Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank Senator Gallagher for raising this important issue. I am aware he has a keen interest in healthcare and does a great deal of work in Monaghan and Cavan in respect of my portfolio, which is disabilities.I am very conscious of that and I commend him on it.

I would like to assure the House that the Government is committed to the continued development of GP capacity 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. I want to ensure that existing GP services are retained and that general practice remains an attractive career option for newly-qualified GPs. As of 31 December 2018, 2,491 GPs hold GMS contracts with the HSE and this is continuing to increase year on year. A further 430 GPs hold other contracts to provide services such as immunisation, heartwatch, methadone and cancer screening. HSE community healthcare organisation area 1 has confirmed that there are currently 25 GMS GPs in Monaghan covering 27 GMS panels and there are 34 GMS GPs in Cavan covering 37 GMS panels. Two locum panels for Ballyjamesduff and Drumalee were advertised in the national newspapers last weekend, with a closing date for receipt of completed applications of 15 March 2019. The HSE primary care unit is also processing two open entry GPs for Cavan and is engaging with all GPs holding locum panels to discuss the future of these panels. All GMS panels are assigned to a GP and currently there are no panels without a GP. The HSE is not aware of any GMS patients without a GP in Cavan-Monaghan. There are nationally agreed processes in place that ensure that any person who cannot access a GMS GP will be assigned to a GP.

The Government is aware of workforce issues facing general practice - and I take on board the points raised by Senator Gallagher - including the influence of demographic factors, and has implemented a number of measures to improve recruitment and retention in general practice. These include changes to the entry provisions to the GMS scheme to accommodate more flexible shared GMS-GP contracts, and to the retirement provisions for GPs under the GMS scheme, allowing GPs to hold GMS contracts until their 72nd birthday, as well as the introduction of enhanced supports for rural GP practices. These steps should help to address the future demand for GPs by enticing GPs who may have ceased practicing for family or other reasons back into the workforce, facilitating GPs to work past the standard retirement age and encouraging more GPs to work in rural areas.

There has been a huge expansion in the number of places on GP training programmes in recent years. In 2009, there were 120 GP training places available, and in 2018, 193 places were filled, an increase of around 60% over this nine year period. The objective is to continue to achieve annual increases in the number of training places available while ensuring that all the places are filled.

It is acknowledged that there are many challenges in general practice. I agree with Senator Gallagher's point on this issue. That is why the Government remains committed to engaging with GP representatives on the development of a package of measures and reforms to modernise the current GMS contract.

Talks between the Department of Health, the HSE and the Irish Medical Organisation, IMO, as the established GP representative body, are continuing. Agreement on the delivery of these service improvements and contractual reforms has the potential to facilitate a substantial increase in the resourcing of general practice on a multi-annual basis.