Feakle unlikely to get GP

AS the HSE seeks to fill the vacancy for a GP in Feakle for a third time, the president of the National Association of General Practitioners (NAGP), Dr Conor McGee, says, as things stand, he does not expect a successful outcome.

Dr McGee, who is based in Scariff, was commenting on the latest advertisement of the Feakle doctor’s position, which has opened the vacancy up to GPs based in other practices, as well as new doctors.

“Since the job in Feakle became vacant, it had been advertised twice but it is worth noting that it has received a total of no applications. That’s not a comment on Feakle, that’s just people looking at the figures and saying I won’t be able to make a living out of this, and that’s what it is. There is something very tragic about it, though, because there has been a doctor in Feakle for 50 years. It is a great service to have locally and it is sad to see it gone. I’d be surprised if the post gets filled, as it stands,” he said.

Speaking to The Clare Champion in March, Dr McGee predicted that at least four doctors in Clare would be forced to leave general practice over the coming years because they could no longer afford to stay in business.

This was in response to Government cutbacks, implemented under Financial Emergency Measures in the Public Interest (FEMPI). There were four rounds of cuts and the last two saw the value of medical card holders to practices reduce significantly.

“The third and fourth FEMPI cuts were quite targeted and were aimed at rural practice and at the elderly. They reduced the ‘value’ of the rural patient and the elderly patient,” he said.

The cuts amounted to a 38% loss in GPs’ income over the past three years, according to the NAGP. For every medical card holder, a medical practice will now receive a reduced stipend of €9.80 per month, or less than €118 per year, whether that patient attends the service once a week or once a year.
“That €118 is essentially the cost that the Government pays the practice for looking after the person. That’s a flat fee, that’s the money that is there from which you run your practice, so the net effect of FEMPI 3 and 4 has grossly damaged private income, and it has basically meant that practices like Feakle are in my mind not financially viable. We are currently working off 2002 levels in terms of the value of your GMS patients, but overheads, tax, everything is significantly higher.

“It is not really feasible to run small practices. It is certainly not feasible to run practices in rural areas and it is even not feasible to run practices with older populations in urban areas. I did make the prediction that practices would close, based on current Government policy. That’s now happening in Clare and it is happening elsewhere,” he added.

The issue has exercised the NAGP to organise a protest outside the Dáil next Wedneday.

“Never before have doctors collectively presented themselves to say we totally fundamentally disagree with how you are running the health service. Our dissatisfaction and grievances are primarily aimed at James Reilly, and I’d like to make it clear that we are quite excited and looking forward to meeting the new minister, Leo Varadkar, and working with him,” he said.

Local councillor, Pat Hayes said the situation in Feakle is yet another example of a rural service being lost.

“The doctor’s practice is a new service that is coming under huge threat. Feakle is a prime example of that. The FEMPI cuts are causing tremendous difficulties for practices. In terms of Feakle, I would encourage any doctor to look clearly at a rural practice that has potential in my view. If we can’t get a full time doctor in the area, then at least we should get a partial service,” he said.

There are 170 medical cards assigned to the Feakle area, which are being serviced by Scariff at present and, if a new practice opens, the 170 card holders are transferred to that practice.

Councillor Hayes believes that “encouragement should be given to new doctors to get a full practice in a community” and that “the HSE should endeavour to try to ring fence medical cards and encourage private patients to use the new service”.

He added that, as there is no retirement age for doctors that the HSE should look into implementing a policy where those wishing to practice after retirement could do so within an existing practice in favour of operating their own.

He believes, “There is no reason in the world that services like doctors and post offices shouldn’t be subsidised from the national exchequer to try to keep services in areas and I see no reason why the State shouldn’t intervene here. This is the nail in the coffin for lots of communities,” he said.

He commented that services bring people into an area and a lack of services can ultimately cause people to leave.

“It has a knock-on effect for rural communities. It is part of an overall picture emerging around the West Coast, the lack of services and losing a doctor out of Feakle affects the communities of Feakle, Flagmount, Killanena, parts of Tulla and parts of Scariff that have always used the service in Feakle,” he said.

Commenting on the value of medical card holders to a practice, Councillor Hayes said he was surprised to learn they were worth just €118 per annum to a practice.

“When you average it out if a patient is seeing a doctor 52 weeks of the year it isn’t much than €2 a day to the doctor and if it’s just 12 times in the year it’s only €10.Whereas if you could get five private patients in a day at €40 or €50 per patient it would sustain the business,” he said.

Michael Collins, chairperson of Feakle Community Council, said people in the area are disappointed since the departure of their new doctor.

“We’ve had a doctor all our life in Feakle and it has left a hole in the parish. Now we have nobody, and people don’t know what to do”.

Meanwhile, individuals are also trying to keep a practice in Feakle. Niall Smyth, owner of the old creamery building, where the current medical practice is based, said, “I will give the premises rent free in the initial period and after a reasonable time it would build back up to the going rate. It is just an incentive for someone and at least they wouldn’t be worrying about rent for the first few months anyway.

“We are all indebted to the banks and I’ve a huge mortgage on that premises, and it is a building that already houses Ciúnas and Clare Bus but in the interest of the community I’m doing this because we want to keep the community alive. If it’s the doctor today, it’ll be the post office tomorrow and somewhere else the day after and we have to fight to keep the services,” Mr Smyth said.

Dr McGee said he is aware that public representatives and the community are working very hard to secure the post, but he said “the harsh financial reality is because of current Government policy small rural practices really aren’t financially viable”.

By Carol Byrne

By Carol Byrne