Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Senator Cummins for raising this issue. It is something I am very familiar with myself. We come from the same constituency.

As the Senator is aware, GPs are self-employed practitioners, and accordingly, they may establish practices at a place of their own choosing. The HSE fulfils its obligation under the Health Act 1970 in providing GP services to patients who hold a medical card or GP visit card through the GMS service. Most GPs, over 2,500 of them, hold a GMS contract to provide this service. The HSE becomes actively involved in the recruitment of a replacement GP when a GMS vacancy arises. While the campaign is ongoing, a locum doctor or other interim arrangement is put in place to provide care to the patients on the GMS panel concerned.

As a result of HSE recruitment, the number of GMS GP vacancies has fallen from 34 in April 2023 to 23 last November, and it has remained at 23 since, less than 1% of the total number of GMS panels. Five of the vacancies filled were long-term vacancies that were vacant for over 12 months. With regard to the vacancy in Lismore, the HSE has advised that a full-time GP service continues to be provided, maintaining the integrity of the vacant GMS panel of 861 patients. When previously advertised, a successful candidate chose not to take up the vacant position. The Lismore vacancy will be readvertised this month with the aim of securing a permanent GP as soon as possible. I take on board the points the Senator has made, especially with regard to the two cases he referenced. One was about a person who has specific needs, and how she would like to deal with a female doctor - I can understand that - and the other was about somebody who was living closer to the Tallow area. Unfortunately, the job was advertised. It was accepted, and then for reasons unknown the person did not take up the position, which anybody is entitled to do, so it is being readvertised.

With regard to the HSE and working with them on other similar cases, it works very hard to get a GP into a practice where there is a GMS list. While that is ongoing, the GMS list is frozen, which is standard practice. If the list is not frozen and patients move to other doctors who might have availability or room on their list, what happens then is that if a GP is looking and the list is being depleted, they might not apply for the job. That is normal procedure, where a GMS panel is frozen prior to the post becoming vacant and for up to three months after the vacant post has been filled. When the vacant post is filled, after three months the panel opens again and then people have the opportunity, if they wish and another doctor has availability, to move.

While the HSE may move a GMS patient from a frozen panel, each request is examined individually and patients are only moved under extenuating circumstances. One can apply to be removed from the list. This helps to ensure that the vacant panel does not diminish, remains viable and is still attractive to entice a new GP to apply for the position permanently. It is important to note that for the two cases the Senator mentioned, they can apply to be moved from a frozen list, and each case is looked at on a case-by-case basis.