05 January 2017
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General practice needs more resources to tackle ED crisis


The Irish College of General Practitioners, the professional body for general practice in Ireland, has expressed its concern at the latest crisis in the country's emergency departments in hospitals around the country.

The College strongly believes that this crisis is a perennial but predictable one, which is due to a confluence of several complex problems, including massive and historic underfunding of general practice and social care, the removal of public hospital beds, and the massive underfunding of general practice.

The Chair of Communications at the ICGP, Dr. Mark Murphy, said:
"The Irish healthcare system remains in a perennial, but predictable, crisis, reflected by over 600 persons waiting on trollies daily. These vulnerable patients, admitted to hospital with severe medical and surgical complaints, are forced to reside in dehumanising and unsafe conditions, due to a shortfall in the capacity of public hospital beds. We must expect more from our healthcare services. The Irish citizen pays as much or more than in other systems internationally where better care is provided for the same spend. The trolley crisis is a confluence of several complex healthcare problems, chiefly exacerbated by massive and historic underfunding of general practice and social care, together with the removal of public hospital beds from the system over the past decade."

He added: "There is the massive underfunding of Irish general practice and social care- Ireland spends 3.2% of its public health budget on GP- the UK spends over 8% and will increase this to 11%."

The ICGP reiterated that the current crisis reflects the ongoing impact of the FEMPI cuts on general practices around the country, which has led to a serious manpower shortage and pressure on existing family doctors.

  • Chronic disease management in general practice: It is known that the Irish population is ageing, with resultant increases in the prevalence of chronic illnesses. Without optimal management of chronic illness, increased unscheduled presentations and admissions to hospital will result. Unfortunately, patients with chronic illnesses are unable to be cared for in their own communities - due to underfunding, the lack of modern GP contract and severe shortfalls in capacity.
  • Community supports: Senior citizens would prefer additional supports in the community setting to enable them to live independently in their communities, at home or in adapted accommodation. The funding of Home Care Packages is essential to the provision of adequate services to elderly patients, providing autonomy and dignity. Without community supports, elderly citizens are more likely to end up admitted in hospital and will stay in hospital longer, before discharge, exacerbating the bed capacity crisis.
  • Out-of-hours GP: The out-of-hours GP setting has seen an inexorable rise in attendances over the past several years. As capacity increases, without additional resources, there will be a spillover of attendances to our Emergency Departments (with the possibility of increasing admissions).
  • Manpower crisis: There is a manpower crisis in the Irish medical profession, especially in general practice, with both younger and establishing GPs choosing to emigrate rather than set up in practice, under difficult working conditions.
  • Access to diagnostics and outpatient waiting lists: Public patients are unable to access diagnostic services in a timely manner. Over 500,000 thousand people remain on an outpatient waiting list to get an opinion from a consultant, often for many months. As a result, patients' conditions worsen and they will require emergency admissions, instead of community-based care. This problem especially affects elderly individuals with complex medical problems who are eligible under the medical card scheme.

"Politicians have ignored the voices of doctors for too long. Now, more than ever, we need to address the primary problems causing this healthcare problem. We will need an effective primary care system, and better use of public hospital beds, so patients do not always have to enter the hospital through one door- the Emergency Department. We need a modern, well-funded GP Contract to ensure patients can have access to evidence-based and cost-effective policy for community care. We also need to urgently reverse the tide of emigration, low morale and uncertainty amongst new and established doctors", said Dr Murphy.

The ICGP is concerned that negotiations for a new GP contract will commence this month, without the provision for increased funding for patients seeking care in communities, in 2017. ICGP is willing to play its part for a new GP Contract, but only if the necessary funding is present- that is how we can put patients first.


Aileen O'Meara, ICGP Communications Advisor
087 2239830 media@icgp.ie @ICGPnews