Martin O’Leary articulating his views from the audience at a public meeting in Swanlinbar on the issue. Picture: Sean McMahon.

‘Pilot initiative’ planned by HSE

The HSE says it has been committed to the “continuance and provision” of a GP service in Swanlinbar since the last permanent GP retired there in 2020, and confirms it is now at an “advanced stage” of working toward implementing a new “pilot initiative” to address the issue.

A spokesperson for the HSE informed The Anglo-Celt this week that in “normal circumstances” the public health provider works with the retiring GP to ensure a “smooth transition between managing the logistics of recruiting and appointing a new GP” and them then taking on the ‘Panel’ of medical card patients from the outgoing doctor.

The “challenge” says the HSE is the “gap in the starting and finish dates” between a new and old GP taking up the post.

GPs are not employed by the HSE but are instead contracted to the role.

During this “gap period”, the spokesperson explained that the HSE “becomes directly responsible for the provision of medical services to medical card and GP visit card holders assigned to this practice until a new GP is permanently recruited to take charge of the practice. This involves the HSE paying a recruitment agency to employ a locum doctor to fulfil the role of ‘Doctor in Charge’. Such measures are only ever temporary and are intended to end on the appointment of a permanent GP to take over the General Medical Services (GMS) Panel.”

Failing the appointment of a new GP, however, the “next step in recent times in many areas has been dissolution and distribution of the panel” to neighbouring GP practices. This, however, is “not the preference of GPs or neighbouring GP practices”, accepts the HSE.

“In respect of Swanlinbar, since the previous GPs’ retirement over three years ago, the HSE has endeavoured to recruit a permanent GP to take over the GMS panel. These are open recruitment campaigns advertised in the relevant HSE websites, medical websites and various other avenues. The HSE has advertised and re-advertised the permanent GP post for Swanlinbar on numerous occasions without success, with the last being campaign held in Q3 2023. Clearly this is not a satisfactory position for patients and the HSE.”

The spokesperson added: “This challenge is not unique to Swanlinbar and it is accepted by HSE and GPs/INMO, that there are challenges in maintaining GP services in isolated rural and disadvantaged urban communities across the country.”

They point to a national GP Agreement in 2023 between the HSE, Irish Medical Organisation and the Department of Health.

“A dedicated section of this agreement is aimed at addressing these [challenges] and the targeting of a pilot initiative,” said the spokesperson.

The HSE confirmed it is “now at an advanced stage in working up this pilot initiative proposal”.

In respect of Swanlinbar, any such proposal would envisage a GP being located on site in Swanlinbar for three full days per week - Mondays, Wednesdays and Fridays - with a commitment to increase the service on site to include Tuesday mornings and Thursday mornings “if required”.

A practice nurse would be “available on a part-time basis”, which the HSE says will “enhance the range of services available” to patients locally.

Patients would be able to avail of the Chronic Disease Management Programme, Men’s health, Women’s health, menopause consults, insertion of coils, implants, all minor surgeries, stitching of wounds, smear tests, vaccines, ENT services including ear wax removal and cryotherapy of warts.

The HSE spokesperson told the Celt that a review period is “built in” to the new proposed pilot initiative.

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