Seanad debates

Tuesday, 23 January 2018

Business of Seanad

General Practitioner Services Provision

2:30 pm

Photo of Tim LombardTim Lombard (Fine Gael)
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I have raised this matter concerning the SouthDoc service in Kinsale, County Cork, because of a public meeting held there several months ago. The lack of a dedicated SouthDoc service in Kinsale has not been addressed since 2014 when we lost it due to a merger between two existing services in Bandon and Kinsale. Since then, the community in Kinsale has not had a dedicated SouthDoc service based in the town itself.

SouthDoc services are a key part of the social and economic fabric of Kinsale and how it does its business. It is a large town with a significant urban hinterland and a thriving tourism industry which sees the town's population quadruple in the summer months. Due to the age profile of some of these tourists, the lack of the SouthDoc service has become an issue over the past several years.At a public meeting I attended with other public representatives, it became apparent that it is a major issue in the town. I want the Minister and the Department to look at where we are going with the SouthDoc service for the people of Kinsale. There are genuine concerns not only for the residents but also for the tourism industry. It was taken away in 2014 because of financial constraints, but it is now appropriate to look at reinstating this service. The physical infrastructure, the building, is still there. All we need is the will on the part of the Department and I hope I might get some news on that today in order to progress this very important issue.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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I thank the Senator for raising the issue. The Government is committed to enhancing primary health care services - including GP services - throughout the country.

Patient needs for health care can arise at any time and GPs contracted under the GMS scheme must make suitable arrangements to enable contact to be made with them, or a locum or deputy, for emergencies outside normal practice hours. While GPs are not obliged to participate in out-of-hours co-operatives as a means of meeting the contractual requirement, such services have been developed and expanded over time and are now an essential part of our primary care services. This helps to ensure that, to the greatest extent possible, that urgent care needs are met in the primary care setting.

SouthDoc operates and provides out-of-hours GP services in Cork and Kerry. The HSE provides funding to support this service including the costs of triage nurses, call centre, treatment centres, drivers, cars and receptionists. Of more than 215,000 patients that SouthDoc dealt with in 2016, approximately 10,000 were from the Bandon and Kinsale area. In 2013, SouthDoc undertook a review of the service across the Cork and Kerry area. The review considered issues such as levels of activity, availability and sustainability of GPs in each area as well as value for money. This review resulted in changes to service delivery in a number of areas, including Kinsale. SouthDoc took the decision to establish the main centre for this area in Bandon, and base the doctors there on weekdays from 6 p.m. to 11 p.m. and for the weekend service, while retaining a treatment centre in Kinsale. After 11 p.m., one doctor on-call is based in the Bandon treatment centre and travels out as required. If a backlog remains at the 11 p.m. handover, the second doctor will remain on duty as required to deal with the patients waiting to be seen. The levels of activity in this area and the access to an alternative location within a distance of 19 km were key considerations when making the decision.

The HSE has advised that at least two doctors continue to be on duty in the area, supported by additional doctors when necessary. The doctors are also backed up by the wider SouthDoc infrastructure and resources including triage nurse team in headquarters. For all those in Cork and Kerry who contacts SouthDoc, a patient's condition will dictate the appropriate treatment and its delivery location in line with clinical protocols. Patients are contacted directly and given a suitable appointment time in the appropriate location which may be in either treatment centre or could be a home visit in the case of a patient being unable to travel. At all times, the progress of each patient is clinically managed on an individual basis in line with that patient’s condition. The HSE has advised that 80% of all patients are treated within 90 minutes of initial contact.

Photo of Tim LombardTim Lombard (Fine Gael)
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I thank the Minister of State for his very detailed response on what is a very serious issue for the people of Kinsale. I hope there will be a review at some stage into the service to see if this station could be reopened, particularly at night. That is the key issue. There is a feeling in the town that this needs to be looked at. If the Department were doing a review, it might consider Kinsale in light of that review.

Photo of Denis O'DonovanDenis O'Donovan (Fianna Fail)
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I am sure the Minister of State will be only too glad to accommodate the Senator.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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Of course. The HSE primary care division is carrying out a review of all out-of-hours GP services and obviously this issue will be looked at in line with others. Obviously, it is in my constituency and I am very familiar with it. I have also sought engagement with GPs in the Kinsale area to ascertain their feelings on it and to see what issues arise. As it is in my constituency, I will be more than happy to progress the issue.