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General election to get GP treatment?

CLARE doctors have not ruled out the possibility of fielding a candidate in the general election if Government does not approve a rescue package to save rural practices.

Local GPs are prepared to consider entering the political arena if Health Minister Leo Varadkar doesn’t sign off on funding of an estimated €13.8 million nationally to safeguard the future viability of such practices.

The possibility increases the pressure on Clare’s three Government TDs – Fine Gael deputies Pat Breen and Joe Carey and Labour’s Michael McNamara to deliver on previous commitments before a public meeting in Corofin Community Hall on Thursday, January 7 next.

Almost 300 people packed into Corofin hall last month to support a campaign to reverse cuts imposed on rural practice over the last four years.

The organisers secured a commitment from Deputies Breen, Carey, McNamara and Fianna Fáil’s Timmy Dooley that they would attend the January 7 meeting.

Speaking to The Clare Champion, Dr Liam Glynn claimed the Government has been “foot dragging” and “time wasting” on this issue for months and stressed the time for talking and promises is over.

Asked if Clare GPs would run a candidate in the general election, Dr Glynn did not rule out the possibility.

“It would not surprise me if GPs in rural Ireland decided to take matters into their own hands. Dr Jerry Cowley, who attended our last meeting in Corofin, ran a very successful campaign and was elected to Dáil Éireann.

“It has happened before and doctors are in a situation now that is much more extreme. Our backs are to the wall in relation to this issue. We have got commitments and timelines from our local public representatives. If that is not going to be delivered, we know that something radical has to be done and I think people will consider it,” he said.

Dr Glynn warned the Government needs to sanction a comprehensive package to save rural practices.

His concerns were shared by INMO GP committee member, Dr Michael Kelleher, who said it is not beyond the bounds of possibility that local GPs would run a candidate in the four-seat constituency.

Dr Kelleher was a member of the INMO negotiating team that met with Department of Health officials twice a month for the last 18 months concerning a new GP contract.

Having worked in Lahinch for 30 years, Dr Kelleher claimed general practice had been “set back by 20 years” by cuts delivered over the last four years. He warned the reality for rural communities is there is no prospect of replacing an aging GP workforce, one third of which are over 55, unless the cuts are reversed.

He claimed cuts in primary care result in much more expensive secondary care. He estimates it would cost the Government in the region of €13.8 million nationally to restore adequate funding supports for rural practice.

The Rural Practice Allowance, which is €16,216 per annum, entitles a GP to full subsidies and allowances. It is intended to support practices in areas with small populations and remote locations. Generally, the supports apply to single-handed practitioners.

If the GP has a small list of 400, their panel will be treated as being at the maximum for annual leave, study leave, medical indemnity refund, practice secretary allowance and practice nurse allowance. With 400 patients, the GP would be entitled to roughly a third of the value of the practice supports. The leave can be priced at €9,000 per annum contribution to locum expenses.

However, Dr Kelleher pointed out this is a contribution only and a GP would likely pay out in the region of €22,500 in order to be able to claim the €9,000.

Practice secretary allowance is €24,069, while nursing allowance is €37,822. The GP can only claim these allowances if he/she employs the staff and the entire allowance goes towards the employee in question.

Assuming that each GP may have half the existing entitlements already, the cost of the allowance is, on average, €50,000, including the financial grant element. There are currently 167 rural practice allowances in existence. This gives a total approximate global cost of €8,350,000 to restore the rural practice allowances.

Dr Kelleher estimated it would cost about €5.5 million to restore the distance coding financial support.

By Dan Danaher

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