Christopher O'Sullivan (Cork South-West, Fianna Fail)

I thank Senator Kennelly for raising this Commencement matter, which I am again taking on behalf of the Minister for Health. He is absolutely right. We have the same service in Cork South-West. I understand that reconfigurations have happened over recent years and that these have caused concern. Consolidation and reconfiguration happen, and this causes concern. I hope to allay some of those concerns. If there are any questions I cannot answer, I will revert to the Minister.

I will outline how the service works. GPs are private practitioners. Most of them hold contracts with the HSE for the provision of health services on its behalf. GPs contracted under the general medical services, GMS, scheme are required to make suitable arrangements to enable contact to be made with them or with a locum or deputy for urgent care outside of normal practice hours. The GPs participate in GP out-of-hours co-operatives as a means of meeting this contractual requirement. As the Senator will be aware, the SouthDoc co-operative provides out-of-hours urgent GP care within Cork and Kerry. While they are private organisations, the HSE provides substantial funding to support out-of-hours co-operatives through service level agreements, so the HSE does have a role here. There are many factors involved in the delivery of the SouthDoc service including the availability of doctors, staff and infrastructure. Delivery of the service is supported by a bespoke patient management system and a call centre where all patient calls are acknowledged, documented and triaged. The co-operative provides a medical service to a population of approximately 736,000 in addition to visitors to the area. It dealt with over 200,000 patient contacts in 2024.

SouthDoc constantly reviews its service provision to ensure its continued viability. With specific regard to Listowel, a service consolidation plan was implemented in January 2024. Three doctor teams, those at Castleisland, Listowel and Tralee, were consolidated to provide a more sustainable out-of-hours service to the people of north Kerry. While routine appointments are scheduled in Tralee, the service plan includes the retention of the Listowel treatment centre for urgent appointments based on clinical need. A dedicated home visit division then provides care for patients unable to attend an out-of-hours treatment centre. In addition, the plan includes the direct employment of doctors to supplement the local GPs in the out-of-hours service and the addition of locum doctor supports at weekends and on public holidays.

SouthDoc has advised that these changes were essential to maintaining the SouthDoc service in the north Kerry area. It reports the implementation was necessary to alleviate service pressures that were undermining the sustainability of both the daytime and out-of-hours general practice service for patients. The HSE advises that the revised model of service is showing positive results, with both Listowel and Tralee reporting an increase in expressions of interest from GPs to join daytime practice in these areas. SouthDoc states it is committed to the long-term continuation of the provision of the out-of-hours service in the north Kerry region. All treatment centres in the area remain available to the out-of-hours service as necessary. The provision of this service will continue to be evaluated by SouthDoc and the HSE on an ongoing basis.

That is an outline of the consolidation efforts that were made. Similar efforts were made in Cork South-West, which did cause concern. From what we have seen so far, there has not been a drop-off in the level of service patients are getting. The critical point here, which the Senator alluded to, is trying to attract GPs to work in areas like north Kerry and Cork South-West. That is the key challenge. The more GPs we can get to take up positions in rural areas, the more comprehensive an out-of-hours service we can provide. I hope this consolidation will attract more GPs to the north Kerry area, which would allow the service to get back to the levels the Senator has talked about.