Saturday 24 February 2018

Parents seeking free GP care for children face ‘postcode lottery’

Hundreds of doctors still refuse to sign up to under-six scheme

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Click to view full size graphic
Fianna Fáil TD Jack Chambers
Eilish O'Regan

Eilish O'Regan

Many parents who want to avail of the free GP care for children under-six scheme are facing "a postcode lottery" with hundreds of doctors still refusing to sign up to the service.

New figures show nearly half the GPs in Dún Laoghaire, in Dublin, are not participating in the scheme, which was introduced last July to give all under-sixes free doctor visits.

Nationally, 2,283 GPs are providing the service to 367,000 eligible children and growing numbers of surgeries warn they are struggling to cope, having experienced a "tsunami" of visits over the winter months.

Often the child has a very minor complaint. One GP said: "Every minor snotty nose is now brought to the doctor to collect a prescription for antibiotics."

Around 495 doctors, many of whom insisted they could not safely handle more patient demands, are still charging parents fees of around €50 a consultation.

It means that parents are having to switch family doctors to find one who will provide the service or else pay the private fee.

Nationally, around 82pc of GPs are signed up, according to the information obtained in a parliamentary reply by Fianna Fáil Dublin West TD Jack Chambers. "The scheme was introduced in good faith. But it was driven through without a proper analysis of how GPs could cope with the additional workload," Mr Chambers said. "The HSE figures show the number of doctors in the scheme has stagnated.

"I know from talking to GPs that a lot of their concern about workload have come to fruition and that waiting times at surgeries have increased.

"They cannot cope and it is one of the reasons why patients are ending up going to hospital emergency departments.

"Pushing out a GP appointment for a few days opens the risk of a condition worsening. It is essential in this reformed Dáil that we all work constructively to target more spending at primary care. This scheme needs to be realistically deliverable."

The figures given to Mr Chambers by Brian Murphy, the HSE's National Director of Primary Care, show that the lowest participation rates are in parts of Dublin and are at just 60pc in the south city area.


Only 62pc of GPs in Dublin north central are in the scheme, while in Limerick it still stands at 79pc. It is highest in Roscommon at 97pc. And almost all GPs in counties Clare, Sligo, Leitrim and Wicklow are taking part in the service.

Dr Stephen Murphy, a GP in Cabinteely in south Dublin, said he did not sign up and has lost hundreds of patients as a result.

"I did not sign and have no intention of signing. I regard it as an appalling contract. We have stuck to our principles at a personal cost," he said. "But some patients are coming back. They are finding that they were attending practices that could not cope with the workload.

"I have had a lot of difficult conversations with people who have been patients of mine for many years. But a number of parents have joined us because we have not signed and many existing patients chose not to apply for the card.

"Our practice would have to find another 15 to 20 consultation slots a day to cope. As it is we are fully booked the whole time. I did a co-op out of hours evening session recently. It was two-and-a-half hours before I saw a single child with a temperature. They were coming in with runny noses and they were a bit off. I saw about 10 kids with nothing wrong with them."

A recent survey of the scheme's impact on around 200 GPs generated mostly negative comments. One said: "Too busy, less time with sick patients."

Another said the waiting room was a "crèche", according to the Gorilla survey conducted by doctors to measure medical opinion.

A GP said it was "horrific from December to March".

A doctor dubbed it the "after-six card" because so many working parents bring a child to after-hours co-ops.

A spokesman for the Department of Health said GPs were getting about €500m under the overall General Medical Services scheme.

Irish Independent

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