Wayne O'Connor: 'Perfect storm' brews on medical front line
A healthcare crisis is looming as GPs close their books, with a shortage of doctors willing to take on the vital role, finds Wayne O'Connor
The phone rings four times before it is mercifully answered by a kind, compassionate voice. Soon the woman's tone turns regretful.
"I am sorry," she says, "but we are not taking on new patients at the moment. Our books are closed and there are 50 people on our waiting list."
The Sunday Independent is not keen to become number 51 and asks if she could recommend another doctor. She suggests one, but it is 25km away from where the enquiry was made.
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Concerns voiced by the Economic and Social Research Institute (ESRI), as well as doctors and patients groups, that people will be forced to travel long distances for medical care because of a GP shortage are very real. This investigation proves those fears are built on solid ground because almost every second practice (44pc) is shut to new patients at present. This creates problems that spread through the health system.
Over the course of the Sunday Independent's inquiries to 336 GP practices nationwide, we encountered rejection 148 times.
In other cases, this newspaper was told it was not possible to register with particular doctors if you were already affiliated with a GP nearby. In most cases, this is because there are people on waiting lists who must be prioritised over those already associated with another GP.
Staff regularly asked if we were a private patient or medical card holder. We were told medical card lists were full but there was limited room for new private patients.
Other doctors have a vetting-type process in place where they seek to assess a prospective patient's needs before committing to registering them with their practice. They offer future patients an appointment, or send forms seeking information about the person's medical history, any medication they may be using, their family's history of medical problems, if they smoke or drink, have health insurance and even if they are right or left-handed. They then promise to report back when they have reached a decision after assessing the application.
However, more often that not a compassionate voice returned a simple, "No, I am sorry," when asked if the doctor can see a new patient.
The Irish College of General Practitioners (ICGP) fears the problem is set to get worse. Some 700 GPs are due to retire within the next seven years, it says. It estimates 300 new doctors must come on stream every year to deal with the crisis. Just 190 are going into training this year.
"We don't have enough GPs for the number of patients and the growing population," ICGP spokesman Dr Liam Twomey said.
"We are entering the perfect storm - a growing population with fewer doctors, against a backdrop of greater complexity of care, greater demand and a Government policy to expand free GP care despite the lack of doctors to meet growing demand. Ireland has 68 GPs per 100,000 people, compared to 110 in Canada and 120 in Australia."
Stephen McMahon, of the Irish Patients' Association, believes Irish doctors working in these countries must be tempted home and new graduates encouraged to stay. "There is a looming crisis ahead with far more implications for the health and well-being of people than Brexit," he warned.
"It is an ominous sign."
We make 350 phone calls to get national picture on healthcare
The Sunday Independent made more than 350 phone calls to GP practices over the past month to shed light on the availability of doctors in every community across the country. Our aim was to demonstrate what issues patients encounter when trying to access medical care.
Each practice was asked: “Are you taking on new patients?” In some cases we were met with a straight response. When we were told “no” there would often be an apology.
Sometimes, another practice would be suggested by the person answering the call. When we heard “yes” this would be followed by some chat about opening hours and how to register before our reporter resisted disclosing personal details and politely brought the conversation to an end.
In other instances the practice sought personal details. “Is it for yourself? Who am I speaking to? Where are you living? Are you a private patient or medical card holder?”
To deal with such questions it was necessary to exchange information.
Our undercover journalist posed as somebody who was new to the area. He was a prospective private patient looking to register with a local GP practice.
This element of subterfuge was justified as the only accurate way of verifying the response a member of the public would receive. The investigation was carried out in a manner similar to a secret-shopper survey.
Not every call to a practice was successful. In some cases the doctor was away, out on call or nobody was available. However, on 336 occasions a Sunday Independent journalist spoke to somebody and posed the question.