A GP shortage has hit Naas
Naas is facing a potential medical crisis because of a chronic shortage of family doctors. A number of GPs working in the town have either retired or cut back on their working hours.
This means it is almost impossible for individuals or families to be accepted as patients at the reducing number of established practices. It comes as the population of Naas is set to increase dramatically — some 1,000 homes are or will be under construction in the town.
A Naas-based GP told the Leader that the Health Services Executive is to blame because it fails to recognise the costs of setting up a practice and because doctors are trained to work in existing group practices.
“Most of the doctors working in Naas are well over 50 and the costs involved are discouraging young doctors from setting up as a traditional practice,” said the GP.
“If I retired tomorrow, I’d have to let all my staff go and a lot of my pension would go to pay redundancy. There is no incentive to open a practice.”
There are now circa a dozen full-time equivalent doctors in Naas across seven GP practices and this represents a drop of about 25% since four retired.
The doctor also said there is no clear career path along which a GP can progress, unlike within a hospital setting where a doctor can aspire to becoming a consultant.
“The HSE expects doctors to be business people in order to run practices, but we’re not trained for this. In other countries there are better structures.”
The doctor added there was not a single application to take over a GP practice in Naas when it was advertised recently.
“The HSE has to ask why it is so unattractive. At the same time the number of of HSE management staff increased by 15%.”
The doctor also criticised the reduction of payments to GPs by the HSE as part of the Haddington Road (public service) pay agreement — even though GPs didn’t sign up to this.
This means there is a huge disincentive to take on work, the GP added, accusing the HSE of turing community practice into “a dumping ground.”
Consequently, more and more people are flocking to the KDoc service which “is bulging at the seams.” Some doctors work 10-12 hours a week with KDoc on top of their normal working, which goes well beyond 40 hours a week.
“KDoc is not set up to manage long term medical conditions; it’s firefighting. It’s an urgent care until you go back to your own practice,” the doctor said.
The Irish College of General Practitioners, the professional body for GP practice has predicted a fall of 1,000 in the number of GPs working in Ireland over the next decade “due to a growing population and increasing complexity in chronic illnesses.” Over a third of Irish GPs are aged over 55 and 155 are over 65.
“While the number of GPs in training is steadily increasing, many Irish GPs emigrate to Australia where working conditions are better and financial security is guaranteed. The ICGP has also criticised the fact that pay cuts of 35% imposed during the financial crisis have not been reversed “making it more difficult to pay for new doctors and staff — and for new doctors to establish practices in areas of growing population.”
“It has warned that general practice can’t meet the needs of a growing population, especially in areas of high population growth, without more spending and resources.”
The HSE said it does not have any vacant GMS (medical card) posts in Naas “and have not been notified of any GPs retiring in Naas in the foreseeable future”.
However it says it recognises that the population of the Kildare is growing and there is a demand for GPs.
“In recognition of this the HAS has worked to improve primary care facilities with new centres in Naas, Newbridge, Clane, Kildare town, Celbridge and Kilcock recently opened.”
A spokesperson said further work is ongoing with the HSE GP practice unit to look at future population changes “with a view to inform future planning of additional primary care facilities.”
The spokesperson said the HSE works with the ICGP to to recruit and train GPs, adding there are 14 specialist GP training schemes embracing hospital work and supervised general practice work.
“Also, a process has been in place since 2014 to modernise ad update the contractual arrangements with 3,000 GPs who whole contracts.
This has resulted in contract change to cover free GP care including for under 6s and over 70s, diabetes patients, children with asthma, blood pressure monitoring and higher fees for suturing, bladder catheterisation and primary reproductive services.
The HSE says it is working to retain GP services in rural communities and to enhance the childhood immunisation programme.