Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank the Senator for raising this issue. General practice is at the heart of primary care, and a robust general practice and GP out-of-hours service is essential to the delivery of primary care health services. As the Senator will be aware, GPs are required under the General Medical Services, GMS, to make suitable arrangements to enable contact to be made with them, or a locum or deputy, for emergencies outside of normal practice hours. Most GPs meet this obligation through GP out-of-hours co-operatives that facilitate the provision of GP services outside of normal surgery hours. The Westdoc co-operative provides out-of-hours GP services in Community Healthcare West, covering counties Galway, Mayo and Roscommon. It is acknowledged, however, that the Westdoc service does not extend to certain rural areas within the region. This mainly refers to GPs in east and west Galway who are not members of Westdoc. The four GPs in Moycullen, Roscahill and Oughterard are not Westdoc members. As such they operate a rota between them in respect of the out-of-hours cover.

While GP out-of-hours co-operatives are private entities, the HSE provides substantial funding to support the out-of-hours co-operatives, covering a wide range of costs. Since the emergence of the Covid-19 pandemic, the HSE has provided out-of-hours co-operatives with a support grant to ensure continuity of care. In addition, the HSE continues to support GP practices and out-of-hours services through the provision of personal protective equipment, PPE, supporting safe service provision in the context of Covid-19. HSE funding for Westdoc is provided through a service level arrangement with HSE Community Healthcare West. In 2021 and 2020, the organisation received approximately €4 million in funding from the HSE. Also in 2018, HSE primary care operations allocated an additional sum of €150,000 for the provision of extra staffing for the Westdoc GP rota to extend weekend cover in north and south Connemara and Achill. However, specific requests for funding for out-of-hours co-operatives must be looked at in the context of the availability of resources and the competing demands for health service funding generally.

The workforce issues facing general practice in certain areas, in particular rural areas, are well recognised by the Government. Rural GMS vacancies can be more difficult to fill as they are often single-handed practices with smaller patient panel sizes, and I thank the Senator for raising that important issue. To increase the number of GPs working nationwide and therefore improve access to GP and out-of-hours services, the Government has increased investment in general practice. Under the 2019 agreement, investment is to increase by 40% or €210 million between 2019 and 2023. Funding has been increased by nearly €144 million up to this year, and an additional €63 million will be provided in budget 2022. For this winter, an additional €10 million in funding is being provided to support general practice nationally, given the extra pressure the winter period can bring, in particular on single-handed practices. The rural practice support introduced previously has been increased under the agreement to support rural GPs and make rural GMS panels more attractive. Improvements to maternity and paternity leave arrangements and a €2 million fund for GPs in disadvantaged urban areas have also been introduced.

The continuing investment in the wider primary care sector will help attract doctors into general practice, as is evident from the increasing numbers of entrants to GP training, from 120 in 2009 to 213 in 2020, with 233 trainees enrolled this year. These actions will help sustain general practice and improve the level of care provided to patients nationwide.