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Dr Maitiú Ó Tuathail: The very future of local GPs is at stake in this election

The election is upon us, and this year’s election will be fought on the three H’s. Housing, Homelessness and Health. The latter is the one which affects each and every one of us, and one which has dominated the headlines for all the wrong reasons into the New Year.

Fine Gael came into power ten years ago, and amongst the many broken promises made by them at that time was “We will end the trolley crisis.” Under Mary Harney’s tenure as minister for health, she declared a “national emergency” when the number of patients on trolleys hit 380 per day. Under Fine Gael’s three ministers for health, that figure doubled, with this year, 760 patients on trolleys on one day last week. This trend, of a deterioration in all healthcare metrics, is one that has continued under Fine Gael.

Waiting lists for procedures and specialist review are longer than ever, and continue to worsen year on year. This December, the number of patient who attended our Emergency Departments and left without being seen were the highest ever. We saw a 50% surge in attendances in GP Out of hour’s services over that same period.

Same day GP appointments are becoming a thing of the past, with the number of people unable to get same day GP appointments doubling over the past year, and in some cases up to two week wait in some locations across rural Ireland. 70% of practices are no longer taking on new patients. In entire counties like Monaghan every GP Practice is full to capacity and cannot take on new patients.

At the core of all these issues is a lack of both capacity and accessibility. Ireland has come 30th out of 30 OECD countries when it comes to accessibility of healthcare. We are at the other end of scale, near the top in fact, when it comes to healthcare spend. How can this be?

As things stand, both capacity and accessibility are due to worsen significantly, with an unprecedented 500-plus consultant posts vacant, 156 GP posts vacant, and 26 communities across Ireland without a GP. Add to that the 700 GPs that are due to retire in the next 3-4 years, and we will see a drop in access to health care in Ireland like never before.

With this in mind, voters should analyse the health manifestos of the various political parties (where they exist) and should challenge the electoral candidates when they come knocking at their doors.

First, they should ask them what they are doing to ensure that you and your family will continue to have same day access to GP services, or indeed a GP service at all, in the future (More GPs and to keep the current GPs we train).

They should be asked what they will do to address the ongoing, crisis within our emergency departments (More hospital beds and hospital consultants).

Finally, they should be asked what they are doing to tackle our waiting lists. (A combination of the above with better access to diagnostics for all).

These are the issues on which this election should be fought. Fine Gael has proposed the extension of “Free GP care” to children under the age of 13. In a utopian society, where accessibility and capacity are not a problem this may be possible, but in a health service where we have no child and adolescent mental health services in areas like the south east, where we don’t have the staff to operate our children’s hospitals outside normal working hours and in a situation where people are actually leaving paediatric emergency departments as the wait to be seen is too long, such a move is nonsensical. Furthermore, it will rapidly add to the reduction in capacity and accessibility in General Practice.

The question we need to ask ourselves is simple, do we want to preserve same day, or indeed same week access to GP services, or do we want to give “well children” access to the GP for free? Because we cannot have both. Capacity and accessibility are directly linked.

(The argument for the extension of care to children under 13, merits an article in itself, but I will shelve that for now)

Fianna Fail’s position on the extension of free GP care to children under 13 remain unclear. Labour will support this measure, Sinn Fein have yet to comment. To go against such a populist move would prove unpopular, but it can be justified, and with simple explanation, the public will understand. The message is simple.

A second major blow to General Practice, is the resignation of Dr Michael Harty from the Dail and his decision not to seek re-election. His reasons, relate directly to his initial mandate to run as a candidate, his inability to obtain a locum to work in his practice while he is in Leinster House. It is tragic that the very reason he chose to stand is the one which is preventing him from standing again.

He did Trojan work as a TD and as Chair of the Oireachatas health committee. He put General Practice on the agenda time and time again, and contributed positively to the creation of the slaintecare report. His lone, independent ane, will be missed in the corridors of Leinster house

It is unfortunate that his expertise were not properly utilised by either the Taoiseach or minister for heath during his time in office. A GP of 30 years, his experience and vison for General Practice should have been invaluable to a young minister for health, who had neither.

This election, the issue for voters is simple. We need to meaningfully address the failings in our health service, before we reach the point of no return, what is at stake, is the loss of General Practice as we know it today.

If you can’t get an appointment with your GP, blame your TD. If you wait 12 hours to be seen in the Emergency Department, blame your TD. If you wait 4 years on a waiting list for specialist care, blame your TD. #GE2020



Dr Maitiú Ó Tuathail is a GP in Dublin 


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