Thomas Byrne (Meath East, Fianna Fail) | Oireachtas source

A robust general practice and GP out-of-hours service is essential to the delivery of our primary care health service. GP out-of-hours co-operatives are largely private organisations. However, since MIDOC out-of-hours ceased operations on 31 December last, the urgent out-of-hours GP service in the area, which was previously run by MIDOC, has been run by the HSE. The service provides out-of-hours GP care for counties Laois, Offaly, Longford and Westmeath. MIDOC GP CLG, a private company, previously co-ordinated the rotas and payments for GPs who worked in the MIDOC out-of-hours service. However, MIDOC made the decision to cease trading on the 31 December 2022. This was despite a long period of prior engagement with the HSE to help address the financial challenges the company faced and financial support to the company provided by the HSE, to allow for the completion of an independent financial review. It was disappointing that despite this ongoing engagement and support, the company ceased trading.

Since December, there has been no change to or cessation of services, as the HSE put in place interim arrangements to provide urgent out-of-hours GP services, including the out-of-hours service at St. Joseph’s hospital in Longford. Since the decision by MIDOC to cease trading, the HSE has been engaging with the Irish Medical Organisation, IMO, and continues to communicate with GPs. The HSE has ensured and will continue to ensure the provision of out-of-hours services until such time as an alternative provider is in place.

It is important to note, however, that the provision of out-of-hours services is a contractual obligation under the general medical scheme contract and, therefore, the decision on who provides the service rests with the GPs. The HSE will support and facilitate this process. The current interim arrangements will continue until at least 2 July 2023, allowing the necessary time for GPs to agree on a preferred out-of-hours provider and to implement the service, which is a contractual obligation under the general medical scheme.

The terms of reference for a strategic review of general practice have recently been published. This review will commence shortly and will be completed this year. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice, including the out-of-hours services and will set out the measures necessary to deliver a more sustainable general practice.