Thousands more GPs are needed in Ireland to deal with the ‘workforce crisis’.
That's according to Dr Diarmuid Quinlan, the Medical Director of the Irish College of General Practitioners, who says that government agencies agree there should be at least about 50 per cent more GPs. The west Cork doctor says that “every GP is trying to do the work of one and a half GPs”.
“Currently we have about 4,000 GPs in the country, and we should have about 6,000,” Dr Quinlan said, adding that there was also a “huge” shortage of GP nurses. "It is them who do all the childhood vaccines and a huge number of the Covid and flu vaccines.
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"Imagine if a parent with their young baby couldn't get their baby vaccines. And that's a really key role that our nurse colleagues play.
“General practice now delivers most of the diabetes care in Ireland. We are responsible for cardiovascular care, looking after people with angina, with high blood pressure, with high cholesterol, irregular heartbeat with stroke, all the women's health initiatives, all of which we really welcome because these are really important for our population.
“But they are a very substantial additional workflow. When I qualified over 25 years ago, most diabetes care was done by hospital specialists in hospitals, and now almost all types of diabetes care is delivered by GPs and GP nurses in the community close to people where they live.”
Medical cards given to children under six in 2015 added additional strain, and the government is now proposing to expand that to all children aged nine later in 2023. "We know that that will increase the demand for GP consultations by about at least 640,000 additional consultations a year,” Dr Quinlan said.
“It's going to create a waiting list when people are unwell.” Another issue for GPs is their ageing numbers: one in seven GPs is aged 65 or over, and while they’re working hard with the HSE to address the shortage by increasing GP trainings, it still takes years for a GP to be fully qualified.
Dr Quinlan said: “We're facing 600 additional retirements in the next three years, The workload is rising, the population is rising, and the GP workforce is static or declined.” The ICGP are calling for the Minister of Health to set up a working group in January of this year to address the crisis.
“It's particularly severe in rural areas where at least in Dublin or Cork, if you're unwell, you can go to your GP or you can go to the GP out of hours and failing that, there's an emergency department probably within five or 10 miles," Dr Quinlan said. "If you live on Achill Island or Skibbereen or up in North Donegal, you're a long way from the nearest hospital and you really do need your GP services.”
Dr Quinlan also describes how much that overwhelming workload actually translates into everyday life. “Most GPs nowadays are working between a 10-12 hour day every day," he said.
"And the general public often don't see that – so many GPs, they're at their desks at 7:30 in the morning. They're often still in their surgery long after the last patient has departed because when the last patient has finished for the day. I then have a stack of hospital letters, screen, and any changes to make to patients' treatments.
"I have requests for prescriptions. I have all the blood tests that I've ordered. I need to review them. And if I need to contact patients about their results, for example, high cholesterol or all blood results. I need to do all of that.”
Many of Dr Quinlan’s colleagues are also in during the weekend to do additional administrative work like checking blood results or managing patients requests. “The pressure of the workload is such that there's so much work that it's not simply feasible to get it through during the normal working day,” he said.
“It's a really busy place. If you ring our surgery often by lunchtime any day, there are no more appointments left that day. So if you have a sick child or if you're someone who's unwell, very commonly we have to say, ‘I'm sorry, we do not have any more problems left’.
"We are now getting waiting lists in general practice, something that was unheard of five years ago. Many, if not most GP practices are no longer accepting new patients. This is a crisis in our GP workforce, but it's also a crisis for the general public.”
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