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GP-hospital relationship requires ‘culture change’

By David Lynch - 04th Dec 2023

Culture change

The working relationship between general practice and hospitals will need to undergo a “culture change” when the six new health regions commence next February, a recent conference heard.

Dr David Hanlon, HSE National Clinical Advisor and Group Lead, Primary Care, was speaking at the HSE National Doctors Training and Planning (NDTP) medical workforce conference in Dublin last month.

Dr Hanlon noted the February date for commencement of the health regions was “an aggressive timeline”.

“But I’m heartened by the pace of it,” he said. “There is a risk that if it just takes so long, it will lose credibility.”

He said the new regional system will need to see changes particularly in the interactions between GPs and hospitals.

“The reality is the centre of gravity in our health system is still in hospitals. They still have the gravitational pull of a lot of the finance and of being large institutions that have a very clear identity,” said Dr Hanlon. “The health regions’ identity is going to be really important, and the cultural change that’s really required to deliver it shouldn’t be underestimated.”

Dr Hanlon said GPs still experience instances where hospitals do not respond to communications they send about their patients.

He said that instigating culture change would require “bringing in leadership from the community; it does mean enabling our general practitioners”.

“The problem with GPs, of course, is that we are also in our own little silo… so there is a real cultural change that will have to be facilitated across all that.”

Dr Hanlon expressed his belief that “we are up for it… but we have to recognise it is a challenge, but I’m really looking forward to seeing it”.

Also speaking at the conference, ICGP President Dr Eamonn Shanahan highlighted the increasing number of doctors in GP training. He also noted that many future GPs are likely to be “portfolio GPs” with a variety of roles and interests during their medical careers.

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