GP black spots: report identifies areas with ‘clear capacity constraints'
A paper on GP supply and demand to be published by the Minister for Health
Jennifer Carroll MacNeill
on Monday finds there is a 'reasonable level of coverage' currently but warns there are 'some areas with clear capacity constraints arising' where the number of GPs has not expanded to meet demographic pressures – especially in rapidly growing or ageing areas.
It also warns that 'inadequate succession planning for retirement may be a risk to the stable supply of GP services in some areas'.
The paper indicates sufficient numbers of GPs are being trained to replenish numbers retiring and the
Health Service Executive
has been effective at providing support where risks stemming from retirements arise. But it pinpoints areas with the highest proportion of GPs 'at risk of retirement with no viable replacement'.
READ MORE
These are in east
Clare
, east
Mayo
, Inishowen and around
Wexford
and
Westmeath
. Some 132 GPs fall into this category, which would represent tens of thousands of patients.
The paper suggests that some GPs could be deferring retirement in areas where services are stretched, and that areas with already-low GP numbers 'face a risk of further destabilisation arising from upcoming retirements with no evident replacement in place'.
Practices with a single GP make up half of services deemed to be 'at risk' from this factor, making them an 'obvious target' for facilitating and incentivising succession planning.
Single-GP practices are more concentrated in west
Galway
, Mayo, west
Donegal
and areas around Clare, east
Limerick
,
Tipperary
, Wexford and
Leitrim
.
The report's authors point out that in Mayo, Clare, Wexford, Tipperary and Leitrim there is also a high proportion of GPs at risk of retirement and a high proportion of 'under pressure' GPs.
It says that in Leitrim, west Galway and north Mayo there has been high population growth – meaning 'not only is there a risk of GP workforce decreasing in the coming years, there is likely to also be high and growing service usage'. If these issues arise, 'there will be areas lacking appropriate coverage of general practice services'.
Ms Carroll MacNeill said: 'We know there are challenges, and this report points out the problems and offers ideas on how to fix them so that GP services stay accessible.' In places without enough GPs or with capacity constraints, the Government will work to place healthcare workers matched with local requirements, she said.
The research will play into a strategic review of general practice due to be published this year
The paper also looked at areas where more GPs are under pressure from larger patient lists relative to the rest of the country.
'Areas that show a high proportion of under-pressure GPs are areas around Inishowen, west Donegal, east Mayo, east Clare, central Wexford, east Westmeath and west
Waterford
,' it finds – although it notes that in some of these areas, neighbouring regions have greater capacity meaning people may be able to travel for care.
However, this in and of itself may prove problematic, with older age cohorts finding it difficult to travel to visit a GP, while it may be more time-consuming for a doctor to make a home call.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Irish Times
2 hours ago
- Irish Times
Public warned to avoid e-cigarettes from two brands after EU health alert
The HSE's National Environmental Health Service (NEHS) is warning the public to stop using e-cigarettes from two differentbrands as they are wrongly labelled as containing no nicotine. The products, for which European Safety Alerts have been issued, were found to contain nicotine at concentrations up to 30 mg/ml, following analysis by the State Laboratory. The products involved are: McKesse MK Bar 700, blueberry, blackcurrant mango and blueberry pear flavours; and Bank Box 18000 Puffs, watermelon ice, strawberry watermelon and blueberry ice flavours. People can return them to the shop where they were bought and retailers have been asked to stop selling them. READ MORE HSE principal environmental health officer Margaret Ruddy said: 'In response to finding non-compliant and unsafe products on the Irish market, the HSE National Environmental Health Service will continue to exercise its full legal powers to protect public health, this includes product seizure, product destruction and prosecutions. 'Retailers should be checking both the products themselves and their suppliers' details before selling them on to consumers.' Retailers who sold or distributed the products have been told to display a recall notice on their premises or on social media.
Irish Times
5 hours ago
- Irish Times
HSE chief tells Oireachtas group that ‘we took our eye off the ball'
'We took our eye off the ball', the head of the HSE Bernard Gloster acknowledged as he sought to explain how the practice known as third-party insourcing had expanded into a multimillion euro industry living inside the public hospital system. A report he had drawn up for Minister for Health Jennifer Carroll MacNeill revealed that in 27 months to the end of March this year, close to €100 million had been paid out on engaging external companies that use HSE-owned facilities and equipment after normal working hours – in many cases employing existing health service staff – to reduce public waiting lists. The report reveals 83 serving or former health staff are acting as directors in 148 companies providing what are known as insourcing and outsourcing – another system which involves buying care in outside private facilities – arrangements to reduce waiting lists. It says 23 of these company directors are employed by the HSE. READ MORE Gloster told the Oireachtas Joint Committee on Health that over two decades insourcing arrangements had grown from 'a small localised thing' to a level where the health system was now overly dependent on it. 'People saw opportunities, entrepreneurially,' he said, although he stressed there was nothing unlawful about being a company director. He defined insourcing as the practice of engaging external companies or third-party providers to deliver services, often outside of normal working hours, using HSE-owned facilities and equipment. 'In many cases, these providers may employ or subcontract staff who are already directly employed by the HSE, effectively re-engaging internal staff through a separate commercial arrangement, typically at premium rates.' The availability of such premium payments for working for insourcing companies, the HSE chief acknowledged, also made regular overtime less attractive. Gloster told Fianna Fáil TD Martin Daly that the focus of hospitals in embracing insourcing had been a rush to do the right thing and reduce waiting lists. However, he argued that the effective governance of insourcing arrangements became 'quite questionable'. Over recent weeks, there have been significant controversies surrounding insourcing arrangements at Children's Health Ireland, Beaumont Hospital and – the public was told for the first time on Wednesday – at Naas General Hospital . Internal auditors have been sent into Naas to look at concerns over the use of National Treatment Purchase Fund financing. Gloster concluded, following his analysis of the scale of insourcing, that it was now time to wind down the whole process. He has recommended to the Minister that insourcing should end by June 30th, 2026. It cannot be shelved immediately as this would leave patients relying on such services in the lurch. But in the meantime, new controls and safeguards will be introduced. Gloster's plan is for the regular health service to carry out the work previously carried out by insourcing, using new, more flexible rosters now agreed with hospital consultants and other healthcare staff. But he warned that if a gap remains, it will have to be filled by sending more public patients to be treated in private hospitals. Ultimately, Carroll MacNeill is expected to decide on whether to call a halt to the insourcing train – which would appear to generate close to €50 million per year for those on board – by the end of July. However, the investigations into allegations of concern at Children's Health Ireland , Beaumont and now Naas arising from insourcing arrangements will likely run a lot longer.
Irish Times
6 hours ago
- Irish Times
Naas hospital voluntarily paused insourcing amid concerns over use of public funding
Naas General Hospital voluntarily paused the use of an initiative to tackle waiting lists , after concerns were raised about the way in which public funding was used. The National Treatment Purchase Fund (NTPF), a vehicle set up to reduce waiting lists, provides funding through outsourcing – the use of private facilities – and insourcing – the use of public facilities and staff outside of core working hours. In recent months concerns have been raised about the way in which the use of insourcing has been governed, after a leaked 2022 report from Children's Health Ireland (CHI) highlighted allegations about potential misuse of these funds. Funding for the hospital was temporarily suspended in light of these allegations but has since resumed, while funding for Beaumont Hospital has also been suspended in light of 'potential financial irregularities'. READ MORE Speaking at a meeting of the Oireachtas health committee on Wednesday, Bernard Gloster , chief executive of the Health Service Executive (HSE), confirmed concerns have also been raised about Naas General Hospital. According to Mr Gloster, the regional executive officer received correspondence outlining potential issues at the hospital. 'It's not unusual when the CHI report.. came the way it did that you would start to see sequentially people starting to express concerns. There is a concern about how NTPF funding was used or governed by Naas hospital. [An] internal audit will look at that,' Mr Gloster said. 'Conservatively' the audit will take about three months, he added. Fiona Brady, chief executive of the NTPF, said: 'Naas of their own volition stopped their own insourcing temporarily while they liaised with myself and my executive team and we are happy they will be rectifying this issue immediately.' Mr Gloster said the issue around insourcing is widespread, and not about individual doctors or hospitals. 'Fundamentally it appears to be a systemic issue, albeit very different in every hospital,' Mr Gloster said. He said there are 'mechanisms of governance' but the 'effectiveness of the governance is probably questionable' in relation to insourcing. In Mr Gloster's report to Minister for Health Jennifer Carroll MacNeill on the topic, published late on Tuesday, he outlines a desire to wind down the use of insourcing by June of next year. The report states that a growth in insourcing without adequate oversight and controls can create conflicts of interest and lead to noncompliance with procurement rules; inequitable use of public funds, risk of abuse, misuse, fraud and low public confidence. Mr Gloster said the risks of insourcing are 'too high for the public', which is why he believes it should be phased out. An 'over-reliance' on the system has developed over time, he said. In the interim, he said there will be new 'protections' in relation to potential conflicts of interests. In recent years, the health service has taken steps to move towards a longer working week, with health unions last week agreeing to work five over seven days – increasing the hours of work outside of a typical Monday to Friday, 9am to 5pm. Mr Gloster agreed the existence of insourcing creates an impediment to the extended working week. 'For as long as we have this type of third party insourcing, we will not get to five over seven in the management of waiting lists,' he said. 'Productivity will not be encouraged and risk of conflicts of interest remain.' The health chief was also critical of CHI's decision to to publish an anonymised version of the 2022 report. He expressed confidence in Lucy Nugent, the new chief executive, and the new board members, but said there is a 'way to go to see whether the entity [CHI] is sustainable in the future'.
