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GPs in sheep’s clothing

20 Oct 2016

IMO GP Chairman Dr Padraig McGarry

Dara Gantly runs the rule over a disappointing Budget for doctors

Do GPs need to dust down their Del Boy sheepskin coats in order for the Government to take notice? According to IMO GP Chairman Dr Padraig McGarry, Budget 2017 had more to say about sheep than GPs, despite the growing problems in primary care.

This quip was in reference to the €25 million Sheep Welfare Scheme, which is intended to encourage younger and part-time farmers to stay in sheep-rearing by awarding them a payment of €10 per ewe. It’s an interesting idea, and one must wonder if something similar might work in general practice?

But that was not the point being made by the IMO, which stressed that the budget offered nothing to GPs but an increased workload and reduced resources. Of most concern was the continuing delay over talks on a new GP contract.

Minister for Health Simon Harris denied that the talks were being put on the long finger, stating that negotiations would begin by the end of the year — a pledge welcomed by the NAGP, which also greeted with enthusiasm apparent ring-fenced funding for the new contract. But how much? And where is it in the Estimates?

All the Estimates show is additional funding of €18.5 million to support developments in primary care services, including supporting complex paediatric cases at home, maintaining increased Community Intervention Team capacity and meeting lease costs of new primary care centres.

The most dramatic development was the promise of a medical card for all children in respect of whom a Domiciliary Care Allowance payment is made — about 10,000 children — although new legislation will be needed to bring this about.

While well overdue, this will be adding to most practice’s workload. And as for the commitment in the programme for partnership government to introduce ‘free GP care’ to those aged under 18, it looks like we might have to wait until Budget 2018 to hear news of the inclusion of the under-12s.

Dr Mark Murphy

The ICGP was also disappointed, stating that the Budget would not reassure GPs in Canada, the UK or Australia that they should return home and could even force more Irish GPs to leave. “Reversal of FEMPI and ring-fenced resources put aside for the negotiation of a new GP contract are a priority and this Budget failed to deliver,” commented ICGP Communications Chair Dr Mark Murphy.

But with a total budget of €14.6 billion, is this not the highest ever health budget — an increase of €977 million on the 2016 budget for current expenditure and €40 million for capital expenditure? The Minister believes so. The provision for 2017 represents, according to the Government, a 7.4 per cent increase on the original Voted Budget for 2016 and a 3.5 per cent increase on the final projected 2016 outturn (given the additional €500m allocated earlier this year).

However, in December 2007, Mary Harney heralded a gross (current and capital) figure of €14.931bn for the HSE, out of €16.156bn for Health. But that, as they say, is history. Yet we should not be encouraging Ministers to rewrite it.

Yes, Budget 2017 will see some relief in the form of reduced prescription charges — but only for the over-70s — the NTPF is getting €15m (rising to €50m in 2018), and additional funding is also earmarked for mental health (if it is spent) and the Healthy Ireland strategy. But the measures represented merely an increase of 3.2 per cent in current health spending, according to the IMO, at a time when the cost of simply standing still was well in excess of that.

Dr Tom Ryan, IHCA President

But there is nothing to address capacity constraints that have arisen from years of cuts in acute hospital and health sector capital expenditure, with the NTPF monies being described as at best a “stop-gap measure” by the IHCA. The Association’s President Dr Tom Ryan remarked that the measures failed to address the “root causes” of the problems in Health, which were inadequate acute and ICU bed capacity and insufficient operating capacity. You would have to agree.

Even the news of an extra 1,000 nurses/midwives was greeted with some scepticism by the Irish Nurses and Midwives Organisation, which questioned whether the drive was an attempt to convert existing agency employment into staff, thus not actually increasing numbers on the front-line. The devil, as they say, is always in the dysphagic detail.

Dr John Duddy, IMO President

“While I note the commitment to increasing the number of nurses in the system, a move like this will have little positive impact if we cannot recruit and retain doctors,” added IMO President Dr John Duddy.

So is the Budget, to paraphrase Del Boy, just another ‘plonker’? And should medics be thinking of ordering an extra hair shirt instead of a fetching sheepskin coat?

The post GPs in sheep’s clothing appeared first on Irish Medical Times.

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