Doctor calls for regulation of GP online services

Co Galway GP Dr Martin Daly said that while the Medical Council “quite rightly” applies stringent standards and rules to GPs, he is concerned by the Council’s apparent hands-off approach to GP online services. 

Dr Daly argued that such services require regulation and inspection to ensure safety and high quality.

 He called for an official multi-agency review of services, similar to that undertaken in the UK (which found unsafe practices within GP online services and issued recommendations), to be completed in Ireland.

 GP online services continue to grow in Ireland and most recently, former Tánaiste and Minister for Health Mary Harney was announced as Chairperson of Dublin-based company VideoDoc, which plans to create 30 jobs in the next 12 months.

But several Irish GPs have raised concerns about GP online services, based on evidence emerging from the UK, where studies have shown that GP online consultations have led to increased antibiotic prescribing, increased referrals to secondary care and rising healthcare costs due to greater hospital activity.

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<strong>Dr Martin Daly</strong>

“The evidence coming from London is it creates demand for secondary care, as its limitations without patient history and examination means it has to be defensive,” Dr Daly argued.

“Where are the Medical Council and insurance bodies in all of this?”

Patients of such services may also not be aware that recordings of consultations are made and owned by providers.

 Dr Daly said that these services are being touted as GP services but that general practice includes continuity of care and safe, face-to-face physical patient examinations.

 Safety is a huge issue, Dr Daly stated. He added that he has no problem with online consultations being conducted by a person’s own GP where the medical history is known.

He noted claims that online GP services offer convenience, better access and reduced patient cost are unproven.

In the UK, healthcare professionals have raised concerns about some online GP services cherry-picking clients by avoiding catering for sicker, older patients.

Dr Daly claimed that this has a knock-on and unbalanced effect on other, more traditional GP services, which are then left to treat these complex patients.

“The bigger picture needs to be considered in all of this,” he argued.

The Medical Council said that doctors providing telemedicine services to patients in Ireland must provide safe and suitable services for those patients.

It states that doctors “should explain to patients that there are aspects of telemedicine that are different to traditional medical practice — for example, a consultation through telemedicine does not involve a physical examination and any additional risks that may arise as a result”.