HSE South West currently has the following opportunity: General Practitioner, General Medical Services Scheme Buttevant, Co. Cork

(Post held under GMS Contract) SWMDS82622

The GMS Panel has 922 patients, approximately.

The GMS Scheme provides for the provision of medical care at general practitioner level for medical card patients. Full details of the scheme are set out in the contract documentation and in circulars/regulations issued by the Department of Health and Children. Doctors participating in the scheme do so under a formal contract for service so they are contractors rather than employees of the Health Service Executive.

The Government’s decision to delay the planned rollout of alcohol health information labelling, is a “serious threat to public health”, according to the IMO President.  

Dr Anne Dee, a Consultant in Public Health, said the delay “until 2028 at the earliest”, places corporate interests ahead of the health and wellbeing of Irish people.

The Government’s action would result in preventable incidences of cancer, increased incidences of liver disease, and harm to children “because of a refusal to fully enact a bill signed into law seven years ago”.

Dr Dee added that the labelling provisions under the Public Health (Alcohol) Act 2018 are a critical tool in reducing alcohol-related harm, particularly when Ireland “continues to experience worsening rates of liver disease, alcohol-related cancers, and foetal alcohol spectrum disorder”.

“This is about giving people the basic information that alcohol causes cancer, liver damage, and harm during pregnancy. These are irrefutable facts. There is no excuse for keeping them off the label,” she said. “The longer this Government delays, the more irreversible damage is done.”

The IMO President further criticised the influence of “vested interests” in opposing the measure.

“We welcome the fact that the Government recently reiterated its refusal to meet with representatives of the tobacco industry in keeping with Ireland’s obligations under international frameworks that recognise health-harming industries. But why is the alcohol industry, which produces a substance that results in the deaths of up to 1,500 people in Ireland every year, treated differently?”

Dr Dee reiterated that the full implementation of all measures in the Public Health (Alcohol) Act “must happen” without any further delay.

The full roll-out of electronic health records (EHRs) will be a “once in a generation opportunity” to transform the Irish health services’ digital infrastructure and dramatically improve patient care, according to the IHCA President.

Prof Gabrielle Colleran was reacting to Government commitments in the updated National Development Plan for 2026 to 2035 on the digitalisation of the health service.

“We fully endorse and support the decision in the National Development Plan to prioritise health digitalisation. This would be transformational in nature and a once-in-a-generation opportunity to catch up on other countries where digital health records are the norm, enhancing productivity, healthcare outcomes, and service experience for citizens.” 

Prof Colleran noted that the health system continues to rely on an “antiquated records model which is desperately inefficient”.

“It also means healthcare professionals are unable to access and assess patient records in a joined-up, real time fashion. This is at a time when governments around the world are turning their attention to how generative artificial intelligence can transform health systems, improving patient outcomes and overall productivity. The gap from where we are to where we need to be is stark,” said Prof Colleran.

The National Development Plan, which will see €102.4bn in capital investment provided over the next five years, with an overall investment of €275.4bn out to 2035, has allocated €9.25bn to health for the period 2026-2030.

The IHCA has urged the Minister for Health Ms Jennifer Carroll MacNeill to ringfence the required funding for EHRs and prioritise the rapid expansion of current hospital capacity to address the growing demand for care from a growing population.

The IHCA added that a “proper procurement and implementation plan” is now required to accompany this investment in health digitalisation, to ensure value for money, avoid delays, and manage any risks presented by the current fragmented EHR landscape, “which is a reflection of the incremental approach taken to date”.

“The IHCA acknowledges that the recent increases in our health budget is a significant step toward addressing such long-standing deficits,” added Prof Colleran. “However, additional capital investment is still needed to build and open all of the required additional hospital beds, theatres, diagnostics and other facilities across our public hospital base in order to reduce bed occupancy rates, address the numbers of admitted patients being treated on trolleys, and reduce the cancellation of appointments and lengthy waiting times for treatment.”

The Trinity St James’s Cancer Institute (TSJCI) has become the first and only cancer centre in Ireland to be accredited as a comprehensive cancer centre.

The award comes from the Organisation of European Cancer Institutes (OECI). OECI accreditation signifies that a cancer centre has met or exceeded robust standards in cancer care, research and education as determined by the OECI accreditation board.

“I am really proud to celebrate the Trinity St James’s Cancer Institute’s remarkable achievement in becoming Ireland’s first and only accredited comprehensive cancer centre,” Minister for Health Jennifer Carroll MacNeill said today. “This prestigious recognition, by the Organisation of European Cancer Institutes, is a testament to the dedication and excellence of the teams at St James’s Hospital and Trinity College Dublin.”

Speaking about the award, Prof John Kennedy, Medical Director of TSJCI, said: “Patients can be confident that the care they receive in such an institution has been evaluated by international experts and found to be of the highest quality.”

Prof Maeve Lowery, Academic Director TSJCI, stated that this designation “demonstrates that our achievements in cancer research, education and patient care are equal to the top centres in Europe”.

TSJCI was the first cancer centre in Ireland to be accredited by the OECI in 2019. Its new elevated status comes after rigorous evaluation by the OECI, adherence to best practice in cancer care, research and education and close cooperation between St James’s Hospital, Trinity College Dublin and St Luke’s Radiation Oncology Network.

Demand for GP consultations will increase by at least 23 per cent by 2040, according to a new report from the Economic and Social Research Institute (ESRI).

ESRI projections find that this significant rise is mainly due to population growth and “to a lesser extent”, population ageing

On the basis of this growing patient demand, the report finds that there will be requirements for an additional 943 to 1,211 GPs by 2040. In 2023 there were approximately 3,928 GPs in Ireland.

The report also concludes that there will be a requirement for an additional 761 to 868 general practice nurses (GPNs) by 2040 are projected, relative to a 2023 headcount of 2,288 GPNs.

“Population growth and ageing will result in a significant increase in the demand for general practice services in the coming years,” according to the ESRI. These increases come in addition to increases in demand arising from recent policy reforms including the introduction of the chronic disease management programme and an increase in the number of people eligible for a GP visit card.

Minister for Health Jennifer Carroll MacNeill welcomed the report, stating that it highlighted the challenge in ensuring that the Irish population continues to have access to quality GP services.

“We are already expanding GP training places by 80 per cent since 2019, now offering 350 places annually,” said the Minister. “Through the International Medical Graduate programme, developed in cooperation with the ICGP, we are recruiting GPs internationally, particularly for rural areas.”

The Minister also noted that the ongoing strategic review of general practice, due to complete its work this year, “will outline new ways to ensure we have the capacity” to provide GP services.

In response to the report, the IMO has said that Ireland’s “critically low” GP numbers will not rise without significant systemic change.

It added that a lack of supports to both establish and maintain GP practices was deterring doctors from entering and staying in general practice.

The Organisation has been warning for many years of the need for ongoing and sustained support for general practice to match the needs of a growing and ageing population.

Dr Tadhg Crowley,Chair of the IMO GP committee, said: “While we acknowledge and welcome the fact that more GP training places have been made available in recent years, this has not been matched with supports for new and existing GP practices which is a major deterrent for doctors and is having a significant impact on recruitment and retention. This has led to our critically low GP numbers today.”

He said that the impact of the Financial Emergency Measures in the Public Interest (FEMPI) Act in 2009 was still being felt.

“General practice was decimated by the FEMPI cuts during the recession and has not yet fully recovered some 16 years later. As a result, we have a severe lack of younger GPs and those who do enter the specialty are hampered by a range of factors – in particular, the costs associated with setting up and running a practice.”

He said that more undergraduate medicine places were needed as a realistic starting point. “If we just increase the number of GP training places, we will only be robbing Peter to pay Paul as other specialties will suffer. Ireland has a lack of doctors across the board, and as such we need more undergraduate places to be made available as a priority.”

Dr Crowley said that along with boosting the GP workforce, it was imperative that the physical infrastructure was also built up to reflect growing demand.

• The report ‘Projections of national demand and workforce requirements for General Practice in Ireland, 2023–2040: Based on the Hippocrates model’ is available here https://www.esri.ie/publications/projections-of-national-demand-and-workforce-requirements-for-general-practice-in

HIQA is “very concerned” at practices at nursing homes described in a recent RTÉ Investigates programme. The Authority was reacting to the RTÉ investigation that focused on two nursing homes, The Residence Portlaoise and Beneavin Manor in Glasnevin in north Dublin.

HIQA noted that inspection reports on both of these centres are currently being finalised and will be published shortly. But it said that admissions to the Portlaoise home had been stopped “as part of its escalatory action”.

The Authority added that following the programme it had “engaged directly” with those responsible for the operation of the nursing homes.

“Our function as a regulator is to ensure that providers are protecting those who use services and ensuring residents are receiving safe, quality care and support. Accordingly, we will be taking the necessary actions with the provider to ensure safe and effective care and support to all residents.”

In its statement HIQA added that its recently published report on findings from nursing homes over the last 15 years of regulation highlighted “how the vast majority of nursing homes are now providing good quality care”.

“It also shows that a small number of nursing homes struggle to maintain compliance with the regulations. Where there is persistent non-compliance with the regulations or where there is risk to residents’ safety, HIQA’s Chief Inspector takes the necessary enforcement steps which may include attaching restrictive conditions to a centre’s registration, such as stopping new admissions to the centre until improvements are made, or in some cases cancelling the registration of a designated centre.”

In 2024, HIQA refused to renew registration or cancelled the registration of 10 nursing homes.

“HIQA will continue its programme of work in nursing homes and encourages residents and their family and friends to engage with us directly about their experiences so that we can support the delivery of safe and effective care and support. HIQA will continue to engage with all nursing home providers, the Department of Health and representative bodies to drive improvements in the sector.”

In 2023, a total of 15,152 admissions for 14,363 patients were recorded to adult intensive care units (ICUs) across Ireland. That is according to the new National Office of Clinical Audit (NOCA) publication National ICU Audit Annual Report.

Other key findings in the report, include that only 33 per cent of admissions from wards or emergency departments occurred within one hour of a decision to admit, although 87 per cent were admitted within four hours.

In 2023 the national average ICU occupancy was 95 per cent, well above the recommended 85 per cent, indicating ongoing pressures on capacity.

Some 80 per cent of ICU patients survived to hospital discharge, “a satisfactory performance” according to NOCA considering the severity of illness of patients who were admitted to ICU.

NOCA said that the report showed that despite sustained pressures on ICU capacity, “Ireland’s ICU network maintained high-quality outcomes comparable to international standards”.

Commenting on the findings, Professor Rory Dwyer, Clinical Lead for the Irish National ICU Audit, said that the report “highlights the resilience and quality of care delivered across Irish ICUs, despite significant resource challenges”.

“While our overall outcomes are encouraging, the data underline persistent issues, particularly in terms of bed capacity and timely admission to ICU. Continued investment and system improvements are essential to ensure critically ill patients receive timely, appropriate care.”

The report recommends investment to expand ICU and high dependency unit capacity, maintaining a focus on timely access to critical care, and further development of ICU outreach services to support deteriorating patients outside of ICU settings.

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A new plan aims to “forge the way towards accessible, affordable, high-quality, healthcare”, according to the Government.

The document, Sláintecare 2025+, was published today.

Critical views on Sláintecare were expressed the recent IMO AGM in Co Kerry. Doctors passed a motion calling on the Government to “clarify” its plans for Sláintecare. During the debate IMO President Dr Anne Dee questioned the implementation of the policy, however, she said the original aims of Sláintecare, such as multi-annual funding, are worth pursuing.

Today, the Minister for Health Jennifer Carroll MacNeill  described the Government’s commitment to health reform as “unwavering” and that the new document Sláintecare 2025+ provides a path to universal healthcare. 

“The full implementation of Sláintecare remains one of the most significant reform programmes ever implemented by the State,” said the Minister.

She added that the success of this new action plan will be demonstrated by “waiting times continuing to fall, the number of people on trolleys continuing to fall [and] the cost of healthcare for families decreasing.”

The Minister today also published the Sláintecare Implementation Progress Report 2024.

As already reported in the Medical Independent last month, this new report shows a reduction in the cumulative daily 8am trolley count over 2024, with numbers down 11 per cent compared to 2023, despite an 8 per cent increase in the number of patients presenting to emergency departments. The volume of weekend discharges (Friday – Sunday) from acute hospital beds increased by 15 per cent in 2024 compared to 2023, while total discharges increased by approximately 12 per cent.

The CEO of the HSE, Mr Bernard Gloster, has confirmed he will step down at the beginning of next March. He will retire from the public service after almost 38 years, including three as HSE CEO.

Mr Gloster said: “I continue to be privileged to serve in this very important role and for the coming months I will be working hard with the board, the Minister, and the Department to advance many improvements and responses to challenges.

“I wanted to bring certainty to the future leadership of the organisation as I am now in my third year as CEO. I have today submitted my resignation to the Chair of the HSE Ciaran Devane and Minister Carroll MacNeill, allowing time to prepare for the next phase of leadership of our health and personal social services.

“I particularly want to thank the Chair and the Minister for the kindness shown to me during this significant personal decision. I will retire from the public service on March 5th, 2026.  I also want to express my deep appreciation to all of our staff for the work they continue to do every day to serve the public.”

Minister for Health Jennifer Carroll MacNeill stated:  “I extend my enormous thanks to Bernard, an extraordinary public servant, who has dedicated himself, seven days a week, to improving the health service for everyone in Ireland.

“Since he took over his position in 2023, Bernard has brought over 30 years of public sector experience to advance leadership across the HSE organisation and I have greatly appreciated his work, his expertise and his friendship in my short time as Minister. I look forward to working with him in the coming months to continue our good work to advance a health system that works better for all.”

The Irish College of GPs has welcomed the “highly positive” findings of a new report on the GP led chronic disease management (CDM) programme, issued by the HSE.

The report found that the programme was achieving a “high level of impact” on the health of the population and freeing up capacity in the health service – reaching over 400,000 patients, with 91 per cent of these now receiving routine chronic disease care within the community. 

The report stated that participants had 30 per cent fewer emergency department attendances, 26 per cent fewer hospital admissions, and 33 per cent fewer GP out-of-hours visits.

“This GP led programme has been transformative for eligible patients [those with medical cards or doctor visit cards] living with Type 2 Diabetes, COPD, Asthma and cardiovascular illness – and is a very positive step forward for the provision of care outside of hospitals,” said Irish College of GPs’ Medical Director, Dr Diarmuid Quinlan.

“The findings also demonstrate the power of general practice to deliver whole country large population health impacts when appropriately resourced.”

He added that the “success” of the CDM stems from a strong sign up by GPs with 97 per cent providing the service.

The CDM has been in operation for five years and this is the third report the HSE has published on its impact and reach within healthcare system.

The report Structured Chronic Disease Management Treatment Programme in General Practice showed a decrease in unscheduled admissions to hospitals among patients in the programme.

Dr Quinlan also highlighted the impact on prevention and early detection. “Since 2020, 51 per cent of new chronic disease diagnoses have been made through GPs in the programme. This prevents the need for more intensive hospital-based treatments – this is transforming people’s health journeys and promoting sustainable healthcare practices”.

The full report can be accessed here: https://www.hse.ie/eng/services/publications/primary/third-chronic-disease-report.pdf

The IHCA has launched its position paper outlining concerns and a number of strategic considerations in relation to key elements of the recently published Mental Health Bill 2024.

The IHCA “strongly supports” the Minister of State for Mental Health and Older People, Mary Butler, in reforming mental health legislation. The IHCA engaged with the previous Joint Committee on Mental Health, providing a detailed submission to the pre-legislative scrutiny of the General Scheme of the Bill.

While many of the Association’s contributions are reflected in the published draft Bill, the IHCA believes that several critical amendments and considerations are needed in order to ensure effective and timely care to those who need it most, who can be among the most vulnerable people in society.

Launching the position paper, IHCA Vice-President and Consultant Psychiatrist Prof Anne Doherty said: “While we welcome the broad principles of the Mental Health Bill, we, as an Association, have some concerns in relation to ensuring that legislation is workable in practice so that patients can access services in a timely and care-focused manner.”

“We are keen to see these elements within the Bill addressed as a priority to mitigate against impractical legislation which may only serve to create barriers to treatment and result in an overdependence on the intervention of the State for patient care. We are concerned that if left unchecked, the legislation will undermine the patient’s Right to Treatment in a timely and care-oriented manner.

Overall, the IHCA remains “committed to constructive engagement” with the Department of Health and Minister Butler on legislation that can transform psychiatric care in Ireland, bringing it in line with international best practice.

 “We commend the efforts of the Department of Health to enact positive change in this extraordinarily difficult area of health policy and are keen to see a sustainable framework implemented that avoids delays in treatment and excessive legal burdens and costs being placed on patients within the context of parallel legal processes. Consultant Psychiatrists will accordingly need to allocate additional time to dealing with legal and procedural processes, rather than providing urgent care to patients in an already strained system.

 “The IHCA also acknowledges and supports the principles in the draft Bill in relation to admission of Children to an Approved Centre as outlined in Section 60, however, there will be considerable resource implications given existing staff shortages in Child and Adolescent Mental Health Services that requires immediate address.

“Finally, it is also the view of the Association that the form, timing and content of Care Plans should not be legally prescribed, as these elements need to be negotiated between the clinician and the patient in a co-produced manner for optimum treatment and care pathways.”

The IHCA Psychiatry Symposium is taking place today (Wednesday 16 April).

Government “priority” projects, such as the New Children’s Hospital (NCH), dominate the new HSE’s Capital Plan 2025, while funding is also provided across a range of other areas.

The plan promises to make available €173.29 million to continue the expansion of the surgical hub programme.

This will include the complete construction of the North Dublin Surgical Hub in Swords, Co Dublin.

It also earmarks €35.41 million for primary care in 2025, including specific projects in counties Offaly, Waterford and Monaghan.

In 2025, €17.8 million will be provided to expand and maintain the ambulance vehicle fleet, as well as the provision of “new infrastructure and the modernisation of existing ambulance bases”.

In the section on ‘women’s health’, some €25.71 million is promised to fund projects, such as the New National Maternity Hospital and other areas such as the women’s health hub at the Coombe Women’s Hospital, Dublin.

However, according to the plan, there are a number of “challenges” facing the HSE this year.

These include the impact of current and future construction inflation on all projects and the transition to the new six health regions.

Increasing costs associated with new building standards and building regulations are also flagged, as well as having “sustainable levels” of skilled resources within HSE Capital and Estates required to oversee the delivery of the plan.

The plan provides €200 million towards the completion of the NCH.

However, it is noted that any “fluctuation” in expenditure on the NCH would have a significant impact on the remainder of the capital programme.

Funding for specific programmes include critical care, local injury units, urgent emergency care, elective hospitals, specialist disability services, enhanced community care, older persons and the multi-annual mental health capital plan, currently in preparation.

“Significant investment is made in the acute inpatient bed capacity expansion plan, prioritising patient safety, with developments at varying stages of delivery and a pipeline of additional projects in progress or at design stage,” according to the document.

The 2025 plan contains total funding for the construction and equipping of healthcare facilities of €1.33 billion.

“The continued significant investment in infrastructure underlines the Government’s commitment to improving quality healthcare in a sustainable way,” said Minister for Health Jennifer Carroll MacNeill.

“By increasing capacity in our hospitals and developing the necessary infrastructure to enable greater provision of care in communities, we are getting closer to making the vision of Sláintecare a reality; delivering a quality healthcare service to everyone in Ireland.”

*For full document see https://www.hse.ie/eng/services/publications/capital-plan-2025.pdf