Revealed: Parts of the country at risk of becoming GP blackspots
The analysis for the Department of Health said there may be no family doctors to take up practice when current GPs retire in these areas.
It highlights the pressure on GP surgeries particularly in areas where the population has increased and aged including Cavan, Meath, Kildare, Louth, Westmeath and Wicklow.
There were 3,262 clinically active GPs in 2022.
The practice most at risk of not having a replacement GP are mostly single-handed surgeries with one doctor.
These are mostly found in Mayo, west Donegal, Limerick, Tipperary, Wexford, Leitrim and Galway.
The report calls for better succession planning and more incentives for GPs in areas under most pressure.
It said that capacity constraints can be managed by 2030 through a greater flow of doctors coming from training.
At that point 4,000 graduates and doctors recruited from abroad are due to come on stream as over 1,000 doctors are set to retire.
'Intake to the GP training scheme has increased by 86pc since 2015. Accounting for attrition of graduates and the possibly higher productivity of older GPs, by 2030 around 2.2 GP national graduates will have on-boarded relative to each GP who becomes inactive.'
Inadequate succession planning for retirement may be a risk to the stable supply of GP services in some areas, with single GP practices making up half of the risk group.
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However, the HSE appears to be effective in identifying and supporting panels at risk. Still, there remain a few locations where vacancies persist – these arise equally between rural areas and non-city urban areas, it said.
There is some indication that GPs could be deferring retirement in capacity-constrained areas, said the report.
Young GMS contract-holders often set up in areas that neighbour those with capacity constraints. As such, access to a GP may be feasible in many areas that are identified as having low capacity, but may indicate that people living near the boundaries of the geographic areas travel into neighbouring areas for care, it pointed out.
Just over one in five GPs are in single-GP practices and a further one in five GPs operate from two-person practices.
In areas where single GP practices are common but the population is ageing, general practice nurses and midwives (GPNM) numbers are relatively high, which may be offsetting high service usage. There are strong health service management, health outcome and economic rationales for general practices structured around group practices.
Coverage of major schemes such as the modernisation scheme and the under 6 contract is high. However, uptake of contracts related to the maternity and infant scheme, childhood immunisation, and cancer screening are low in these areas suggesting that continuity of supply in terms of GP workforce may affect access to healthcare.
Meath and central Cork have relatively low uptake of the GMS contract despite being areas with relatively higher cardholding populations
There are areas where average panel size remains high regardless of assumed contract-sharing: in North Donegal, East Mayo, and South Wexford, there are a high amount of public patients and relatively low number of GPs.
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Irish Independent
7 hours ago
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Revealed: Parts of the country at risk of becoming GP blackspots
The analysis for the Department of Health said there may be no family doctors to take up practice when current GPs retire in these areas. It highlights the pressure on GP surgeries particularly in areas where the population has increased and aged including Cavan, Meath, Kildare, Louth, Westmeath and Wicklow. There were 3,262 clinically active GPs in 2022. The practice most at risk of not having a replacement GP are mostly single-handed surgeries with one doctor. These are mostly found in Mayo, west Donegal, Limerick, Tipperary, Wexford, Leitrim and Galway. The report calls for better succession planning and more incentives for GPs in areas under most pressure. It said that capacity constraints can be managed by 2030 through a greater flow of doctors coming from training. At that point 4,000 graduates and doctors recruited from abroad are due to come on stream as over 1,000 doctors are set to retire. 'Intake to the GP training scheme has increased by 86pc since 2015. Accounting for attrition of graduates and the possibly higher productivity of older GPs, by 2030 around 2.2 GP national graduates will have on-boarded relative to each GP who becomes inactive.' Inadequate succession planning for retirement may be a risk to the stable supply of GP services in some areas, with single GP practices making up half of the risk group. ADVERTISEMENT Learn more However, the HSE appears to be effective in identifying and supporting panels at risk. Still, there remain a few locations where vacancies persist – these arise equally between rural areas and non-city urban areas, it said. There is some indication that GPs could be deferring retirement in capacity-constrained areas, said the report. Young GMS contract-holders often set up in areas that neighbour those with capacity constraints. As such, access to a GP may be feasible in many areas that are identified as having low capacity, but may indicate that people living near the boundaries of the geographic areas travel into neighbouring areas for care, it pointed out. Just over one in five GPs are in single-GP practices and a further one in five GPs operate from two-person practices. In areas where single GP practices are common but the population is ageing, general practice nurses and midwives (GPNM) numbers are relatively high, which may be offsetting high service usage. There are strong health service management, health outcome and economic rationales for general practices structured around group practices. Coverage of major schemes such as the modernisation scheme and the under 6 contract is high. However, uptake of contracts related to the maternity and infant scheme, childhood immunisation, and cancer screening are low in these areas suggesting that continuity of supply in terms of GP workforce may affect access to healthcare. Meath and central Cork have relatively low uptake of the GMS contract despite being areas with relatively higher cardholding populations There are areas where average panel size remains high regardless of assumed contract-sharing: in North Donegal, East Mayo, and South Wexford, there are a high amount of public patients and relatively low number of GPs.
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8 hours ago
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Lisdoonvarna GP service 'would be closed' without support
A GP practice in Co Clare has avoided closure after a doctor agreed not to retire and to take over the service in Lisdoonvarna. The post had been advertised twice by the Health Service Executive but failed to attract any candidates. Conor Hanrahan was stepping down from a busy medical practice in Ennis around 18 months ago when he was persuaded to take up the position at Lisdoonvarna Medical Centre. A big factor in accepting the position, he said, was the additional support provided by rural and international graduate schemes. "The previous GP had been operating single-handedly for 30 years here and that's difficult, you know, to get locum cover when you have family occasions ... to even just get a break or holiday. "A lot of the practices along the west coast of Clare have closed down. For example, there was a GP in Quilty, there was one in Doonbeg and they're both gone. "There's a real difficulty getting a doctor in Kilrush which is a good, vibrant town, but there's been a practice vacant there for a good few years. "It's the same up around Mulranny in Mayo, the GP there, Dr Jerry Cowley, has retired and they haven't been able to find a permanent replacement for him." Dr Hanrahan was speaking after a warning was issued of capacity constraints in areas of growing population in Dublin and its commuter towns in Cavan, Meath, Kildare, Louth, Westmeath and Wicklow. The analysis, from the Department of Health, was published today. Dr Hanrahan is part of the Midwestern GP training scheme, meaning that he was able to bring someone with him to train in Lisdoonvarna as well as recruiting from the International Medical Graduate scheme. "Without this support Lisdoonvarna would be closed. It's essential to have this support to remain viable in rural areas. That was the incentive for me to come here to work instead of retiring. "But I'm conscious that not everyone can afford to take on non-EU doctors coming to Ireland for training. A lot of smaller rural practices can't afford to take on a doctor like that, because they have to pay them themselves," he said. Lisdoonvarna has seen its population of around 1,000 expand rapidly in recent years. Up to 1,000 Ukrainian refugees live in the town and surrounding areas along with hundreds of International Protection applicants. Dr Hanrahan said the level of service needed would make the position unsustainable for a single practice GP, adding that the service gets even busier in the summer. "Lisdoonvarna is a tourist town and the region generally gets very busy in places like Doolin, Ennistymon, Lahinch, Kilfenora, the Burren. "So there's a constant busy workload and thankfully we can assist where possible and deter people from arriving into overcrowded emergency departments where a GP can carry out the treatment needed." Dr Hanrahan said the model operating at Lisdoonvarna Medical Centre is the way forward as in incentive to GPs to come to rural Ireland. 'Huge amount of demand' for GP services in Meath A GP in Co Meath has said that her practice, which has only been open for a month and a half, had to close its books to new patients for a time such was the level of demand. Dr Bláthnaid McHugh, from Trim General Practice, said there seems to be "very high" demand for GPs in the wider Meath area. "We opened on the 12th of May and we had to pretty much close the list in the first week, because we were really at a huge amount of demand," she said. "We have opened up again, but at a much slower pace, and even then, we aren't able to reach the capacity of people who have requested to join the practice. "At the moment, it's still myself here, and I'm the only doctor in this practice. And there seems to be a real shortage of general practitioners in Trim and in further afield to Trim as well." Dr McHugh said that the growing population and the retirement of GPs who are not being replaced have put pressure on the system. "I've been working in in the Meath area since I qualified in 2017. When you're working, you're not really aware of of how short the area is, but I can see, you know, over the course of my lifetime, how much the town of Trim and surrounding towns have grown. "There have been some local retirements of GPs there too and it's very hard to to keep up with the pace of the growth of the population." Dr McHugh said she believes a number of measures could be put in place that would help to alleviate the problems affecting the sector.. "I think just having a bit more exposure to general practice [during training] to get a feeling as to what the job actually entails on a day-to-day basis, that might be helpful. "In this practice, I've set up this surgery myself, and I was interested in setting up my own practice for a number of years, and certainly there were bumps and problems in the pandemic along the way that delayed me, but certainly, you know, I've set this practice up and over the last 14 months, and I've had a lot of support from my my colleagues that I trained with locally, and a lot of them, you know, would have the same concerns that I had setting up with. "Just the cost of doing it and then, just the lack of available properties as well. The housing market is big a problem but also the commercial market. There wasn't many places over the last few years that I found that were as suitable as this premises is for this purpose. "I think what would probably help a GP to start up in their own area would be if there was maybe some kind of a support, a kind of grant or something to just help with equipment or with legal costs or something so that it would take a little bit of the pressure off the GPs who were looking to start up. "At the moment, it's really on yourself kind of thing when you're doing that and I think that a lot of people find that quite daunting. "I did myself but certainly, I'm on the other side of it now, and I'm very, very glad that I've done it and I've got massive support from the local community. Really pleased to be here. And you know, certainly it's been very positive experience from start to finish," Dr McHugh added.
