GP co-op cuts to hit patients from March, medics warn

Patients contacting the North-East Doctor on Call service (NEDoC) will face “exceptionally longer waiting times†to see a doctor because of new arrangements which will come into effect from 1st March, according to Kells GP, Dr Peter Wahlrab. He warned that drastic cuts in the service, which will be implemented next month, could have safety implications. “As one of those who set up this service, I am not convinced that we can provide a safe level of cover under the new arrangements,†he said. The Kells GP also indicated that the future of the service beyond the next three to four months remained uncertain because of what the GPs' co-operative calls “draconian cuts†being implemented by the HSE. Dr Wahlrab, who is one of the founders of NEDoC, said that a substantial cut in the number of doctors-on-call, including a 50 per cent reduction in the numbers based in Navan at weekends, is the result of a 62 per cent cut in HSE funding to the GP out-of-hours service. The number of doctor- on-call in Navan on weekends will be cut by half from four to two, and from 6pm to 11pm each evening, there will be just two doctors in Navan instead of three, while from midnight onwards, there will be just three doctors to cover the four counties of Meath, Louth, Cavan and Monaghan. “We came under extreme pressure over the Christmas holidays and from the flu epidemic. If NEDoC hadn't stood in the gap at the time, the entire hospital system would have collapsed,†he claimed. “My belief is that the HSE are wilfully ignoring the risk to the service by pushing these draconian measures, when the people implementing the cuts are protected from cuts by the Croke Park agreement,†he added. The HSE has indicated that the new arrangements are implementing a number of key recommendations contained in the National Review of GP Out-of-Hours services. However, Dr Wahlrab said he didn't accept the findings of the review or that a 62 per cent cut in funding is justified. He said the board of directors of NEDoC wouldn't be able to provide a service with a 62 per cent cut in funding and had decided to subsidise the service on a temporary basis from funds in NEDoC's reserves. This means that the cut in rostering is a 30 per cent reduction rather than a 62 per cent cut. However, he pointed out this couldn't continue for more than three to four months and he had no idea what the outcome would be beyond the next four months. Dr Wahrbab warned that the HSE could not implement such draconian cuts in frontline services without it impacting on other service providers. “If we are not able to attend to people who wish to see us in a timely manner, they may simply turn up at the emergency department, where a chaotic situation already exists,†the GP said. “A&E simply cannot cope with the influx of people could and should be treated by a GP.†Until now, there were four doctors available to cover Meath, Louth, Cavan and Monaghan from midnight onwards. This will now be reduced to three and there will be no doctor in the Castleblayney, Co Monaghan, centre during those hours. At weekends, there are normally four doctors on call in the Navan centre, but this will be reduced to just two from 1st March, while the number in Drogheda will be reduced from three to two. Navan has always had three doctors on call from 6pm to midnight, but from 1st March, there will be just two. Similar cuts will occur in Drogheda and the number of doctors in both Cavan and Castleblayney will be reduced in each town from two to one. Callers to the service always had an opportunity to speak to a doctor before a decision was made to ask a patient to come in for treatment or for the GP to go out for a home visit. Callers will speak to a nurse instead from 1st April. NEDoC operations manager, Arlene Fitzsimons, said this would result in a increase of 10 per cent in people visiting the centres to see a doctor and she warned that patients will have to wait longer. A spokesperson for the HSE said it was implementating a number of key recommendations contained in the National Review of GP Out-of-Hours services that had been agreed between the HSE and the GPs. She said members of the public are asked to note that the NEDoC service is intended for urgent GP calls and is not an emergency service and arrangements for routine GP services should be made during normal surgery hours. She said the HSE was engaging with staff around the changes, which may necessitate redeployment for a small number of staff moving to other areas within the HSE. Patients who require an urgent GP out-of-hours consultation can phone 1850 777 911 where details will be taken by a HSE call-taker. Under the new system, the caller will receive a call back from a nurse who may offer advice to the patient over the phone or may invite the patient to see a GP in a treatment centre at an appointed time, or may deem a house call necessary. The HSE pointed out that NEDoC is the only co-op to operate a GP triage system.