GPs require resources to meet greater expectations

Last month, the Irish College of GPs published a new report entitled Strengthening the Future of GP Care in Ireland. The report reviews progress that has occurred since the College’s 2022 document Shaping the Future. It warns that without sufficient support, the cornerstone of Ireland’s community health system risks being eroded.

The report identifies priorities across a number of areas affecting general practice, such as digital health, quality improvement, and medical education. A common thread across the different priorities is the rising complexity of the specialty.

GPs are now managing a broader range of conditions, leading structured chronic disease programmes, and taking on roles in teaching, research, and service design. This diversification is vital for the future of the profession, but it comes at a time when capacity is already stretched.

As the report states: “Tomorrow’s workforce needs not just more GPs, but GPs with the time, skills, and structural support to lead at multiple levels.”

Fuelled by demographic changes – and service developments, such as the expansion of ‘free’ GP care – demand is climbing steadily. Yet supply has not kept pace. A large proportion of GPs are nearing retirement and recruitment is proving especially difficult for rural and single-handed practices.

“Without sufficient GP capacity, patients face longer waits, reduced continuity, and barriers to timely and coordinated care,” according to the report.

“The consequences are likely to cascade through the health system, contributing to delayed diagnoses, increased unscheduled hospital use, and growing inequity in access – particularly in underserved urban and rural areas.”

The report states that the GP workforce must be expanded, not only by increasing training places, but also by addressing retention, working conditions, and career flexibility.

The College calls for investment in GP training, post-training Fellowships, continuing medical education networks, GP wellbeing, and programmes such as the international medical graduate rural scheme, which it says are essential.

In addition, practice supports and assisting new and existing GPs to run practices will also be needed to sustain services.

The report argues workforce planning must reflect population need and include targeted support for high-need and low-coverage areas.

In this issue of the Medical Independent, our main feature examines the concerns some GPs have about the amount of new clinical guidelines being produced for the specialty. These guidelines – which are developed by the College, and the HSE, among others – can be time-consuming for GPs to implement – especially given the existing pressures on services. They also do not often come with additional resources or support.

According to Dr Austin Byrne, a GP based in Waterford: “The College is doing a great job; they need to provide up-to-date educational standards. But where the College starts to recommend that visits are mandatory or certain activities are mandatory, it becomes incumbent upon the payer, which is the State, to fund those.”

Dr Byrne pointed to the 2019 agreement between health management and the IMO as an example of what can be achieved when new programmes are properly funded. But he added that costs have increased since this time.

The expectations on GPs have never been greater. But without adequate resources, primary care will continue to struggle to meet rising demand.