Out-of-hours GPs needed now more than ever

THE delay in restoring full GP out-of-hours services in Clare three weeks after a HSE pledge about the full resumption of facilities has been criticised by a union official.

In response to a Dáil question from Deputy Maurice Quinlivan, the HSE primary care general manager, Carmel McLaughlin outlined that Shannondoc has commenced the restoration of services on September 14 in Hospital, Roscrea and Thurles and that planning is underway in relation to the resumption of services in Clare.

Ms McLaughlin stated the HSE and Shannondoc were committed to the full restoration of all services that were in existence pre Covid-19.

A spokesperson for Shannondoc said, “As a result of the Covid-19 public health crisis, a consolidated model of service operating from five treatment centres across the Mid-West was introduced at Shannondoc.

“These changes were necessary to protect its GPs, its front-line staff and patients while ensuring the service was maintained to patients through-out the mid-west during the crisis.

“Shannondoc, supported by the HSE, has recently approved an enhanced model of service across the Mid-West. This service is dependent on the availability of healthcare staff including Locums/GPs.”

All patients will continue to receive a full clinical nurse triage assessment over the phone.

A team of doctors to be available in each county and will be deployed in a dynamic and responsive manner. This team of doctors will be available to attend local treatment centres including Ennis and Miltown Malbay in County Clare.

Shannondoc acknowledged there may be exceptional circumstances where a patient may be required to travel to the next nearest treatment centre i.e. the doctor is required to carry out an urgent home visit elsewhere or Shannondoc challenges associated with filling shifts.

“Shannondoc has put in place an e-prescribing facility and will be rolling out a video consultation system as part of their enhanced model of service.

“This programme will ensure that the needs of all patients in need of Shannondoc out-of-hours services are met.”

Patients living in West and North Clare, who require out-of-hours GP services, were forced to travel longer distances after Shannondoc reduced the number of treatment centres due to the devastating impact of Covid-19 earlier this year.

Last March, Shannondoc confirmed Ennis Treatment Centre would become a two doctor centre following the amalgamation of the Ennis and Shannon cells.

The Miltown Malbay Treatment Centre became a one doctor centre and was serviced by joining up the Kilrush and Ennistymon cells..

Kilrush and Ennistymon previously provided a service from 9am to 7pm on Saturday and Sundays while Shannon used to operate from 6pm to 11am from Monday to Friday and 9am to 10pm on Saturday and Sundays.

SIPTU’s Assistant Industrial Organiser for the Mid-West, Mark Quinn has confirmed Shannondoc services still haven’t been fully restored in Clare more than three weeks after the HSE written commitment.

The Spanish Point health official confirmed he has contacted the HSE to inform them what was stated in the Dáil reply hasn’t taken place.

He claimed the “watering down” of Shannondoc services has serious implications for people in the Mid-West.

Calling for all the Shannondoc services to be re-opened, Mr Quinn said the out-of-hours service was needed now more than ever coming into the winter months.

Confirming he is in negotiations with the HSE concerning Shannondoc, Mr Quinn said he believes the out-of-hours GP co-operative should be taken over by the HSE.

The Clare Champion has received correspondence that claims drivers from West Clare are now redeployed to Ennis for work.

The correspondence outlined a mobile doctor from Ennis covering from Ballyvaughan to Loop Head. With no receptionists in Ennis, the correspondence claimed this work is now being completed by drivers and nurses.

A well placed source claimed locums are stretched working extremely long shifts but are doing the best they can in the circumstances.

A mobile Shannondoc service is now in operation and, even though the Shannon Health Centre, which previously accommodated Shannondoc has re-opened, it no longer operates as a base for the out-of-hours service.

In the Mid-West, a mobile Shannondoc car covers from beyond Tarbert in Kerry to Kilfinnane in East Limerick and on to Doon/Cappawhite on Tipperary border across to Parteen and Meelick in Clare.

The Shannondoc service in Killaloe is closed and Clare patients are told to go to Limerick or Nenagh, which covers Killaloe to beyond Thurles back to Newport and up beyond Roscrea and Portumna, County Galway.

In West Clare, all patients are told to go to Miltown Malbay between allocated hours or go to Ennis.

All home visits covered by Ennis or patients sent to Ennis or Limerick.

Speaking to The Clare Champion, Deputy Cathal Crowe said during this medical crisis there has never been a greater need for a medical out-of-hours GP service that can deal with a whole range of non-emergency health needs.

“A lot of people have become more reliant on the Shannondoc service over the last six months. People are less inclined to present themselves at the ED in University Hospital Limerick (UHL).

“The need for a Shannondoc service is very important going into what will probably be the most challenging winter.

“Shannondoc is an essential front line service. The whole health care system has been pumped with an additional €600 million for the Winter Plan – the largest ever investment.

“Finance shouldn’t be a problem in our health care system, it is being pumped with additional money on a weekly basis.”

Deputy Crowe stressed the government recognised the health system needs to be properly funded

The Fianna Fáil Deputy confirmed he plans to highlight the importance of the out-of-hours GP service in the Dáil.

As a family unit, Deputy Crowe recalled they have only used accident and emergency services in UHL only on two occasions in five years compared with seven or eight contacts with Shannondoc to deal with various issues.

“I place a very high value on the services provided by Shannondoc. For most people, Shannondoc is their first port of call in a time of trouble, probably more so than the ED.”

Dan Danaher