Wednesday 16 January 2019

Patients turn to the emergency services as GP numbers tumble

Doctors renew warning on cuts made after crash

Dr Peadar Gilligan warned the medical service is in crisis. Photo: Shane O’Neill
Dr Peadar Gilligan warned the medical service is in crisis. Photo: Shane O’Neill
Dr Lisa Cunningham speaking at the IMO AGM in Killarney, Co Kerry. Photo: Shane O’Neill
Eilish O'Regan

Eilish O'Regan

Patients are being forced to resort to out-of-hours GP services because they cannot get a daytime appointment.

The out-of-hours skeleton services are supposed to deal only with emergencies but increasingly they are faced with patients who are calling on them for routine care.

The other alternative is for patients to queue in overcrowded A&E departments.

The stark predicament faced by patients who are frequently being turned away by overwhelmed GP practices was spelled out at the Irish Medical Organisation's annual conference yesterday.

The HSE is now forcing some doctors to take on extra medical card patients even though their lists are closed, and this can cause more distress.

GPs renewed their call on the Department of Health to start talks by mid-April on reversing the cuts in fees for treating medical card holders and other public duties such as vaccinations which were imposed during the recession.

Dr Peadar Gilligan, an emergency consultant in Beaumont Hospital who is the incoming IMO president, warned that the medical manpower crisis is having reverberations across the health service, including GP practices.

"There are record levels of emigration among recently qualified and working doctors, record numbers of resignations from consultant posts and a failure to attract applicants to key positions as consultants and GPs," he warned.

Meanwhile, a Dublin psychiatrist said many patients who suffer from depression are not getting the optimum treatment on time because of a lack of psychologists.

Dr Matthew Sadlier, a psychiatrist in north Dublin, said pateints can face a delay of six to nine months to see a psychologist.

They can be prescribed antidepressants as treatment but they would also benefit from also having "talk therapy".

He said around 390,000 of the 1.6 million people in the medical card scheme were on antidepressants.

"Among the adult population as a whole between 10pc-12pc are taking antidepressants," he added.

"The best treatment is a combination treatment. Antidepressants allow the brain to grow and adapt. They help you to learn new ways of coping.

"Antidepressants plus therapy is the best treatment."

Dr Sadlier said modern antidepressants have few side effects.

"Talk therapy helps people to re-frame their experiences," he added. "They can learn coping mechanisms.

"There is also a deficit in occupational therapy, giving people purposeful employment and activities in their life."

He said there was an excellent programme done in Navan Road, Dublin with the Football Association of Ireland, where patients with mental health difficulties took part in football training.

The meeting was also told that many health staff are facing physical and verbal abuse from patients and visitors.

Dr Patrick Hillery, a trainee emergency consultant, said some people became frustrated with delays and vented their anger on staff.

He called for the introduction of mandatory prosecution of people who assault any healthcare professional providing medical aid.

Doctors also supported a motion calling for a time limit of six hours to be imposed for patients on trolleys who need a hospital bed. The target time in hospitals in the UK is four hours and in the United States it is three hours.

It comes in the wake of record numbers of patients on trolleys this winter.

Irish Independent

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