Tim Lombard (Fine Gael) | Oireachtas source

I welcome the Minister of State to the Chamber. I raise the issue of medical cover required on Saturday mornings in the towns of Clonakilty, Skibbereen, Rosscarbery, Enniskeane and Kinsale. Unfortunately, there is a dispute between the GPs and the HSE about who covers what and when. As a result, there is the potential there will be no such GP cover across the entire west Cork. There has been a breakdown in communication and trust. Particularly now when we all need to pull together to deal with the Covid crisis, it does not make any logical sense for the HSE, without consultation, to have pulled payments for Saturday morning cover since last July for a cohort of GPs across west Cork. Since last July, the GPs who cover those Saturday morning clinics have not received payment for those clinics. Effectively, they are working for free. They are providing a service to the community for which they are not receiving payment. That is a change in practice by the primary care reimbursement service without any consultation with the GPs. There has always been a lag in payments and those GPs were expecting to receive payment six to eight weeks later but since July payments were stopped without consultation. There is a fear that an apartheid system could develop with those GPs only covering private patients and not public patients whom they are also obliged to cover. This is a major issue. As the Minister of State is aware, there is a crisis with respect to the shortage of GPs going into GP practice. There is a lack of confidence among GPs about the sustainability of GP practices. As a result of this dispute more and more GPs will walk away from this service. With the Covid crisis, there could be a limit on cover for these Saturday morning clinics in west Cork, which would result in increased activity, particularly in accident and emergency departments, which we would not want to see happen. We want patients to be provided with the medical cover they need in those towns. We do not want them to have to go the Cork University Hospital for it.

I raise this issue because it is of major concern to the people of west Cork. What will happen to Saturday morning medical cover across these towns is part of a major debate. Consultation has failed and there has been a complete breakdown in communication. The HSE needs to actively engage with that cohort of GPs to make sure there is a service on Saturday mornings across those west Cork towns. If not, the outcome will be disastrous. That is the dilemma we face due to a lack of communication, consultation and pre-planning for what should be a key service. Primary health care is a key service and we need to make sure it is maintained. Unfortunately, it is not being maintained at the moment.