Independent TD Brian Stanley has spoken about a shortage of GPs in Laois in the Dail recently.
Speaking directly to Taoiseach Micheal Martin, Deputy Stanley outlined the situation in Laois.
He said: “I raise the problem people around the State have in accessing a GP or getting a GP to take them on.
“It is even more difficult for people who do not have a medical card. It is a huge problem.
“There is a shortage of locum doctors, which leads to problems for some GPs trying to take holidays or leave.
“A recent Economic and Social Research, ERSI, report outlined that we need between 943 and 1,211 to cope with demand.
“The Irish College of General Practitioners has stated that we have a huge deficit.
“It has identified several counties that have a chronic shortage, including County Laois.”
Deputy Stanley says that the emergency departments of hospitals are clogged up with people who ‘should be seen in a community care or primary care setting’.
He says that some go to emergency departments either ‘because they cannot get a GP appointment or do not have a medical card and cannot afford a GP visit’.
He said: “In County Laois, the ratio is, on average, one GP per 1,600 population.
“Only 35 GPs out of 67 in the county take medical cards. At least 700 GPs are to retire between the years 2023 and 2026.
“There are not enough new GPs in training and in many cases, when they qualify, they are faced with a choice of trying to establish a general practice or emigrating.
“Some emigrate because of the cost of trying to establish a practice, pay for premises, hire equipment, hire staff, etc., and the long hours.
“We have a chronic shortage due to the lack of forward planning by all Governments over the previous 20 years. Solutions are needed now.
“We need a major ramp-up of directly employed, salaried GPs working in general practice. The number of training places needs to be increased substantially.
“When young GPs qualify, the HSE needs to actively recruit them and offer them permanent positions.”
In response, Taoiseach Martin said: “I thank the Deputy for raising the issue of primary care and GP provision.
“Undoubtedly, in rural Ireland and in some urban areas, over recent years there have been challenges accessing a GP and getting a GP.
“On the other hand, there have also been significant developments and growth, particularly in terms of the number of places at third level. That has increased very significantly over the last two to three years.
“The work done by the then Minister, Stephen Donnelly, with the Tánaiste when he was Minister for higher education resulted in additional places in our colleges.
“It will take some time for those places to come through. We also secured additional post-graduate education places more generally. That is important.
“We have 179 primary care centres in the country now, which is very significant, and 50 new ones have opened since 2020.
“On chronic disease, 95% of GPs are now signed up to the chronic disease management programme; there were more than 645,000 patient reviews by GPs in 2024; and 92% of patients with chronic diseases are now fully managed routinely in primary care and not attending hospital for managing their condition.
“The number of new entrant GP training places has increased significantly in recent years and is up 350 for 2024.
“College and training places continue to grow and an additional 662 student places have been provided in the higher education sector on health-related courses overall this year academic year, which includes nursing and midwifery.
“The growth is there within the third level colleges but the quality and nature of the work of GPs is changing. That work on chronic disease is essential for outcomes and for the community enhanced care programme.
“A lot of GPs speak very highly of its impact. Overall, our figures as a country on life expectancy are improving because of the stronger role of primary and community-based care and the management of chronic disease, along with public health measures and better quality of work within acute hospital services.
“Our life expectancy is above 82 years of age. Our mortality fell by 11% over the decade 2014 to 2022. The mortality rate for all circulatory system diseases fell by 20% in that period, with heart disease and stroke falling by 28% and 37%, respectively.
“There is another perspective to our health narrative which rarely gets articulated.”
Deputy Stanley thanked the Taoiseach for his reply and said that while he appreciated there was now more training places, he said it will take time for them to work through.
He said: “The one thing we need to do better on is retention of those who are coming out of courses.
“I have outlined to the Taoiseach about directly employing GPs, which the Tánaiste said he is in favour of.
“It was a key part of Slaintecare. We should remember it was agreed here in the Oireachtas nearly eight years ago.
“Primary care and community care are absolutely central to implementation of Slaintecare and are the cornerstone of a public health system.
“We must try to do better on that if we are to improve things. There needs to be a big shift of healthcare from hospitals to primary care settings.
“Our hospital wards are overcrowded, and our emergency departments are bulging. The best we can hope for, with the figures coming through at the moment, is to stand still.
“Standing still is not good enough and we have to do better. Life expectancy is becoming longer, and we will have a lot more people, including a lot more over 80s.
“We need to work better at this and try to have more directly employed GPs to supplement ordinary general practice ones in the State.”
