HSE admits difficulties recruiting GPs in Mid-West

RECRUITING general practitioners in the Mid-West has become more challenging due to the national shortage of family doctors, the Mid-West HSE has warned.

In a statement issued to the Clare Champion, Mid-West Community Healthcare acknowledged it is facing a recruitment and retention challenge in this speciality.

There are currently 216 General Medical Services GMS GPs in the Mid-West. Over the next seven years, 24 GPs (11%) will reach the age of 72, whilst 64 GPs (30%) will reach the age of 65.

The growing population, ageing demographics and the extension of GP visit card eligibility on an incremental basis is also placing an increased demand on GPs.

There is evidence of a significant undersupply of GPs in Ireland at present, and these issues are likely to persist.

By 2025, the predicted shortage of GPs in Ireland will range from 493 to 1,380.

More than a third of doctors working as GPs are not on the Medical Council’s Specialist Register of General Practitioners which is a requirement to become a GMS Doctor.

The ICGP, the professional body for General Practice in Ireland, estimates that in excess of 700 GPs will retire in the next five years.

Many Irish GPs are over 65 and have indicated that the Covid-19 pandemic and workload may accelerate their retirement plans. 

“In this climate, recruiting GPs has become much more challenging. There is also extreme difficulty sourcing locum doctors in Ireland at present.

“The HSE have been proactive in trying to recruit GPs for vacancies in the Mid-West and have run campaigns on local, national and international platforms with mixed success, further highlighting the difficulty in recruiting GPs,” said a HSE spokesman.

This warning comes after the HSE confirmed it received no application for Dr Michael Harty’s medical card patients panel, despite advertisements on three occasions prior to his retirement at the beginning of March.

Two applicants expressed an interest in taking on this panel following a fourth advertisement recently.

Mid-West Community Healthcare has agreed to fund a new Rural General Practice Fellowship in the region to help address the GP shortage.

This will present a newly-qualified GP trainee with an opportunity to work in a rural area where difficulties are being experienced recruiting new family doctors.

Under this initiative, the post holder will study general practice in the University of Limerick before working clinically in a rural area.

Funding has been secured for the first Irish Rural General Practice Fellowships from the National Doctors in Training Programme (NDTP), which has been awarded through the Irish College of General Practitioners.

Up to 40 fellowships have been awarded nationally for all the medical specialities such as emergency medicine and cardiology. Five of these are available for general practice including one for a rural area.

With up to half the medical workforce in general practice, Professor Liam Glynn believes that half of these fellowships should be in general practice.

Professor Glynn, who has been a rural GP in Ballyvaughan for the last 23 years, stressed measures are needed to retain more newly-qualified doctors in Ireland to avoid the UK situation where some patients are waiting between two and three weeks in some areas for a routine appointment.

“People are trying to find innovative solutions to the GP shortage. Other community health organisations throughout the country are considering these new fellowships as an option.

“It provides a bridge from when a new GP trainee qualifies when they may not want to take up a GMS post straight away but it gives them an opportunity to work in these practices.

“A lot of new GPs are interested in combining working with research and training.

“The more experience a new trainee gets in rural general practice, the more likely they will end up working there. We need to change the negative narrative around attracting new GPs to rural areas.

“While rural GPs recognise the challenges facing general practice in rural areas, most of them have spent 30 or 40 years working there so there must be something attractive about it.

“We don’t want to lose any more rural GPs who are an important part of the overall medical infrastructure.”

He pointed out the best way to deliver a cost effective and high quality health service is to support small GP-led teams working with their primary health care colleagues in local communities.

When continuity of healthcare is available in the community, he said it reduces mortality and hospital attendances.

Professor Glynn said the difficulty recruiting GPs for rural areas is now being replicated in urban areas like Thurles where a new post had to be advertised on a number of occasions.

He said a GMS post is a very satisfying and fulfilling professionally.

He acknowledged Maria Bridgeman and Margaret Costelloe who are responsible for community and primary care respectively in the region understand the problems and are doing as much as they can to find solutions.

Stating the Rural General Practice Allowance hasn’t been increased since 2016, he said this needs to be broadened and increased.

Another important measure that should be considered is giving proper medical recognition for people working in rural general practice.

Professor Glynn said the World Health Organisation has made a series of recommendations to improve access to health services for rural and remote populations.

These include targeted admission policies to enrol students with a rural background in health worker education programmes, provide scholarships, bursaries or other education subsidies to health workers with agreements for return of service and develop a policy of career development and advancement programmes.