Shortage of GPs.

palmcut

In my view the major fault with the Health system is that there are not enough General Practitioners.
Many patients cannot get the access to their GP that they require. The GPs are run off their feet and are not adequately resourced or funded.
Many of the patients attending A&E cannot get access to their GP and consequently go to A&E instead.
The first priority of the new Government should be to properly fund and properly fund a GP service.
We need more GPs to work nationwide.
The terms of work provided by an awkward and at times antagonistic HSE need to be urgently reviewed.

Kurtosis

Agree with this 100%, a properly functioning primary care system with properly resourced GP services keeps people out of hospitals and facilitates patients in managing their condition more themselves. With the constraints at the moment, I think even if people can get access to their GP, there is only time to focus on major issues rather than also being able to address small problems and prevent them becoming big ones. It's akin to firefighting, only being reactive as there isn't the time to be proactive.

Some good news is that the promise to increase the number of GP training places survived and is included in the Programme for Government. Of course this is going to take time to actually affect the GP workforce, in the mean time other approaches may be needed such as attracting emigrants back.

ebbsy

That stupid idea of giving free medical cards to U6s has clogged up surgeries.

By the way when are diabetics going to get medical cards ?I work and have type 2. Always paying out.

palmcut

ebbsy wrote: »

That stupid idea of giving free medical cards to U6s has clogged up surgeries.

By the way when are diabetics going to get medical cards ?I work and have type 2. Always paying out.

Type 2 diabetics qualify for an LTI (long term illness ) book. All the prescribed medicines relating to your diabetes are free with this book.
Call into a pharmacy and get the application form. The form has to be completed by your GP.
The application goes to the local Health office and is generally approved in a few weeks.

ebbsy

palmcut wrote: »

Type 2 diabetics qualify for an LTI (long term illness ) book. All the prescribed medicines relating to your diabetes are free with this book.
Call into a pharmacy and get the application form. The form has to be completed by your GP.
The application goes to the local Health office and is generally approved in a few weeks.

Have that bud for 5 years. I mean a medical card for GP and hospital visits.

Kurtosis

ebbsy wrote: »

Have that bud for 5 years. I mean a medical card for GP and hospital visits.

I believe the policy ran into legal trouble on extending GP visit cards on the basis of medical need. This was supposed to be the first step in extending free GP care to all, so instead the policy switched to the over 70's and under 6's.

ebbsy

I made an appontments to see kdoc at 10pm in the vista. Paid 65e. Was seen at 3 am. It was like a creche there.

There was people getting refunds and leaving.

echo beach

penguin88 wrote: »

I believe the policy ran into legal trouble on extending GP visit cards on the basis of medical need. This was supposed to be the first step in extending free GP care to all, so instead the policy switched to the over 70's and under 6's.

Nobody has ever explained what exactly the legal problem was. The Health Act is clear that medical cards should be given on the basis of economic need, which is fair enough, but then how can they be allocated on the basis of age?
A more likely explanation for the change of heart is that extending it on medical need would completely overwhelm the system.

However they chose to extend free GP care it will require more doctors who should be in place before, not after, the extension and changes to work practices that also have to be agreed in advance.

gctest50

echo beach wrote: »

............, but then how can they be allocated on the basis of age?..........

keep them alive long enough to squeeze their savings out of them instead of leaving it to offspring to squabble over

Kurtosis

echo beach wrote: »

Nobody has ever explained what exactly the legal problem was. The Health Act is clear that medical cards should be given on the basis of economic need, which is fair enough, but then how can they be allocated on the basis of age?
A more likely explanation for the change of heart is that extending it on medical need would completely overwhelm the system.

However they chose to extend free GP care it will require more doctors who should be in place before, not after, the extension and changes to work practices that also have to be agreed in advance.

I'm not familiar with what it was, but there must have been some mechanism in 2002 that permitted automatic entitlement to medical cards for the over 70's the first time around.

As you say though, it's ridiculous that free GP care is being extended without the necessary capacity being there first.

Traumadoc

Diagnostic access is key to improved efficiency in the health service , if GPs had direct access to community based radiology they could prevent many patients having to go near outpatients or emergency departments.

newacc2015

ebbsy wrote: »

That stupid idea of giving free medical cards to U6s has clogged up surgeries.

I was a great idea. But it should require a co-pay. Even if it was €5, people would think twice about bringing their child to the GP. But I suppose you are only marginalising the poor or some other generic response from the AAA-PBP crowd. The health system would require a co-payment for more things. It is ridiculous that you don't a cent to see a doctor with a medical card. My GP will tell you she often a waiting run full of people with a cold, but just want to be sure as it isnt costing them anything. A co-payment would reduce this

Gael23

The problem isn't the lack of trained Doctors, it's the 38% budget cut to GPs that was imposed during the recession that has made a GP practice not a viable proposition for newly qualified GPs, hence they all emigrate.

I fully agree with the OP, General Practice needs recording as a way of keeping people away from hospital. I was in a practice up to 2 years ago were a doctor left and the practice was unable to find a replacement and as they couldn't cope with patients demands with remaining staff levels, the practice closed and patients were distributed to other practices.

newacc2015

Gael23 wrote: »

The problem isn't the lack of trained Doctors, it's the 38% budget cut to GPs that was imposed during the recession that has made a GP practice not a viable proposition for newly qualified GPs, hence they all emigrate.

I fully agree with the OP, General Practice needs recording as a way of keeping people away from hospital. I was in a practice up to 2 years ago were a doctor left and the practice was unable to find a replacement and as they couldn't cope with patients demands with remaining staff levels, the practice closed and patients were distributed to other practices.

A GP gets hardly anything for a medical card patient. But they are constantly in the surgery. Where as with a private patients, they pay €50-60 a visit and 2/3 visits is worth more to a GP than a medical card patient.

A more viable solution is cut funding to GP's again and allow GP's to collect €5/10 off every medical card visit. It cuts down on visiting the Doctor 'to sure', feeling up their time for actual sick private patients. I imagine a sizeable amount of Doctors in high population areas would be considering going fully private if more people are given medical cards

Gael23

newacc2015 wrote: »

A GP gets hardly anything for a medical card patient. But they are constantly in the surgery. Where as with a private patients, they pay €50-60 a visit and 2/3 visits is worth more to a GP than a medical card patient.

A more viable solution is cut funding to GP's again and allow GP's to collect €5/10 off every medical card visit. It cuts down on visiting the Doctor 'to sure', feeling up their time for actual sick private patients. I imagine a sizeable amount of Doctors in high population areas would be considering going fully private if more people are given medical cards

I think they get around €250 per year, open to correction on that figure. There is a case for a copayment as you describe alright but I don't think it's fair to those with a medical care based on medical need. I have one and I've been to my GP 4 times this year so far, one of those was at my doctors instruction: he wanted to do some tests before I saw a consultant. I will say over the years I have gone in a few times "just in case" but I don't have the time to waste t be sitting in there when I don't need to.

cyning

Co payment is a difficult one for me. In the first 15 months of her life my daughter had 52 GP visits. I wasn't a neurotic crazy lets go to the doctor with a sniffle mother: if I brought her in sick on a Monday they often had to bring her back in 2/3 times that week trying to keep her out of hospital, monitoring her. She landed in there fairly frequently too. They really went above and beyond.

The flip side is while we are still frequent visitors (though not as bad thankfully), I see the same faces in and out. I speak to other parents particularly on Fridays going "just in case". It's hard to reconcile the two for me. I know how difficult I would have found paying for every visit. I also know a co payment would cut down on the sniffles and Friday visits.

Gael23

cyning wrote: »

Co payment is a difficult one for me. In the first 15 months of her life my daughter had 52 GP visits. I wasn't a neurotic crazy lets go to the doctor with a sniffle mother: if I brought her in sick on a Monday they often had to bring her back in 2/3 times that week trying to keep her out of hospital, monitoring her. She landed in there fairly frequently too. They really went above and beyond.

The flip side is while we are still frequent visitors (though not as bad thankfully), I see the same faces in and out. I speak to other parents particularly on Fridays going "just in case". It's hard to reconcile the two for me. I know how difficult I would have found paying for every visit. I also know a co payment would cut down on the sniffles and Friday visits.

You are right, and its people genuinely in need that pay the price. But I wouldn't mind seeing s something small, 5 or 10€ as opposed to €50 for a full visit.

echo beach

cyning wrote: »

I speak to other parents particularly on Fridays going "just in case".

The Friday visits, and not just with children, are symptomatic of the problems in getting good quality out-of-hours GP care at weekends. Bank holiday weekends are even worse and there is also an upsurge on the following Tuesday.
With the shortage of GPs this can only get worse, leading to a viscous circle of shorter regular surgery hours and more patients trying to squeeze into them.

cyning

I can understand that... I have huge problems with out out if hours service where they missed my 4.5 weeks old pneumonia, missed tonsilitis and ear infections and 3 times have told us her grommets have fallen out. They are still there. They also can over react when they see her as she gets so sick so fast so have sent her to a&e rather than give her antibiotics. But I accept that it's because she has slightly more complex issues than most kids her age (they hear she's on prophylactic antibiotics and panic!).

But I don't know: I would still never bring her just in case she got worse over the weekend.