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The submission by the HSE UL Hospitals Group calls for a “partial reversal of the recent trend that family practice cover outside 9am-6pm, Monday to Friday, is provided by large co-operatives who undertake the call obligations so that the call doctor may never have had contact with the patient, may not be from the immediate locality, has no access to their notes and is not in a position to confer with the regular GP, if required.”
While the submission states that “we cannot return to the single-handed practitioner 24-hour, seven-days-a-week model”, it calls for “a hybrid model whereby small groups of family physicians were organised to provide cover in the twilight hours, ie, 6pm-11pm and 8am-8pm, Saturdays and Sundays, would be a better system. Cover outside these hours to remain on the large co-operative model.”
Such a proposal is likely to prove very controversial to GPs who participate in co-ops.
The submission document also suggests increasing GP access to diagnostics and allied health professionals, but cautions: “However, high-quality and cost-effectiveness must be incorporated in such an arrangement and advice from GPs as to how this might be achieved should be sought.”
It also notes if access is increased through GPs, it may only result in greater resource utilisation without any decrease in hospital beds. “Therefore, if GPs are going to be given resources, there will need to be an accountability system based on quality of care and outcomes, including hospital avoidance.”