More support needed for rural doctors

GPs working in remote and rural areas have called on the HSE to provide greater support for locum cover, the Medical Independent (MI) has been told.

The call was made as part of a motion unanimously passed at the Annual General Meeting (AGM) of the Rural, Island and Dispensing Doctors of Ireland (RIDDI), which took place at the Hodson Bay Hotel, Athlone, Co Westmeath on 28 June.

Proposed by the newly elected Chair of the organisation, Galway GP Dr Aonghus Flavin, the motion called on the HSE to provide locum cover of €750 per day for 35 days annual leave and 10 days study leave per year.

Last year, the Department of Health launched a new GP locum cover support scheme for 239 GPs in remote and rural areas.

However, under this arrangement, the GP still covers the cost of the locum. The HSE only pays for the administrative and agency costs of finding a locum. More generally, GMS GPs can avail of locum contributions for various types of leave.

Members of the RIDDI believe that much greater support should be provided to rural doctors.

The motion endorsed a position statement from the Irish College of GPs’ rural general practice standing committee, and proposed “two amendments to the current scheme”.

The first was that, for practices in receipt of the Rural Practice Support Framework, a “daily market rate for locum cover of €750 per day is provided fully for 35 days annual leave and 10 days study leave per annum”.

The second was that practices could avail of the scheme through the designated locum agency or could “also be allowed source their own locum cover and submit invoices for payment of same”.

The motion was one of a number that passed at the AGM.

Another called on the IMO GP committee and HSE to urgently address inequities faced by rural dispensing practices and “isolated” GPs.

According to HSE data, there are around 39 dispensing doctors in Ireland currently serving approximately 10,839 patients. In 2017, the number was 65.

The motion called for the restoration and protection of dispensing rights for rural practices where patient access to pharmacy services is limited by distance, transport, age, or vulnerability.

It also called for the introduction of a “realistic and fully funded rural locum support scheme”, with a recognition that sustainable rural practice requires dispensing support and adequate locum cover.

The motion sought assurances that dispensing doctors would not be “unfairly disadvantaged by administrative delays, refusals, or policy inconsistencies that threaten the viability of rural general practice”.

The motion ended with a call on the IMO “to actively engage with the Department of Health, HSE, and relevant stakeholders to implement these changes as a matter of urgency, in order to protect patient access to primary care services in rural Ireland”.

A separate motion, proposed by retired GP Dr Marion Broderick, supported engagement with the Irish Patients Association in the RIDDI’s ongoing campaign to retain dispensing rights. It was also passed.

Another motion, for the HSE to introduce rural health centres in remote areas, particularly on islands, was debated and passed.

Mayo GP and Honorary Life President of RIDDI Dr Jerry Cowley called for HSE funding at market rates for six months’ maternity locum cover for rural practice doctors, as part of efforts to improve staff recruitment and retention. This was passed unanimously.

Speaking to MI, Dr Flavin, based at Roundstone, Co Galway, said that better resourcing was needed to adequately support rural and dispensing doctors.

Dr Flavin raised concern that the number of dispensing doctors nationally had decreased significantly in recent years.

He stated that there is the perception among dispensing GPs that the HSE is not supportive of the group.

“While there does not appear to be a specific policy by the HSE in reducing the number of dispensing GPs, there has been a sustained reduction of dispensing GPs in the past 10 years and the reasons for this need to be researched to ensure any barriers to dispensing are addressed,” Dr Flavin said.

A spokesperson for the HSE told MI that the Executive has “ongoing engagement with the IMO on a range of topics”, including those involving rural doctors.

The 39th Annual RIDDI Conference will take place in Mulranny, Co Mayo, on 2–4 October.