Martin Conway (Fine Gael) | Oireachtas source

I welcome the Minister of State back to the House and thank her for taking this Commencement matter. Shannondoc is a community healthcare service, a co-operative of doctors as it were, in the mid-west region to provide out-of-hours service. We can recall how years ago, doctors were on call all the time. It could be 6 p.m. or 8 p.m. it did not matter; doctors were still on call. In order to give doctors a quality of life and to improve the quality of service, and to ensure that there was a service, the doctors came together and created Shannondoc. That has been emulated around the country. To be fair, the Governments stood up to the plate and did provide resources to support the community out-of-hours doctors initiatives around the country. However, while in some areas they have worked extremely well, in others they have been average or extremely poor.

The experience of Shannondoc in my area has been mixed. The doctors who work in it when they are available are very committed and do a very good job. They can take the pressure off our emergency departments. The problem is that the Shannondoc service has been consolidated and it has been curtailed and cut back to such a degree that there are real challenges to the provision of services. There was a time when there was a Shannondoc facility just outside the towns of Ennistymon and of Kilrush and in other areas. However that has been consolidated and I believe that Miltown Malbay is the only facility that Shannondoc is providing in west Clare. That is a challenge.

There has been Covid and other things but the Minister of State will be very aware of the enormous challenges to the emergency department in University Hospital Limerick, UHL. It is the most overcrowded emergency department in the country. It regularly has 90 to 100 people on trolleys. Many, or at least some of them could be diverted from hospital if they were to present to a Shannondoc-type facility. We have minor incident clinics in places such as Ennis and Nenagh and so on but they close at 8 p.m. If somebody is injured after 8 p.m., it may not be life threatening but if it is something the person is concerned about, in the absence of a Shannondoc facility his or her natural reaction is to go to the emergency department in UHL. That is adding to the numbers. I know that a review of the Shannondoc out-of-hours service has been committed to. I also understand that there may be a national review on the out-of-hours service. The point is about whether we believe in primary care and in trying to care for people within their community as a first response. It may be that people need to attend an emergency department or hospital but the people at primary care level can make the decision that their care must be escalated but in many cases, they can deal with the injury at local level. The out-of-hours doctor service is a critical component of such a service. When someone is injured late at night, they can panic and worry. They may be over-panicked or worried. The out-of-hours doctor service is one which can give them reassurance and provide necessary medical interventions and maybe calm the situation, ensuring that people do not present at the emergency department's front door in Limerick. We want to avoid that where possible.

Is the review happening or has it happened? If not, when will it happen and what is the timeline for a report and recommendations for how we can improve the out-of-hours GP service?