GP burnout: TD says situation is now ‘a major health risk’

• Doctor says system is ‘in crisis’

A CHRONIC lack of cover for local doctors in West Cork now poses a significant risk to public health, a TD has warned, with burnout a major factor.

In one case a GP on the Beara peninsula came back from a holiday completely exhausted because she had the worry of having to close her practice for a day, after failing to get a locum.

Dr Fiona Kelly highlighted the burnout facing GPs due to the manpower crisis. 

‘The future of general practice is in crisis due to a lack of manpower. It’s time that something was done,’ she said. 

Dr Kelly is from Castletownbere and has been working on the Beara peninsula since 2009. After a tough year during which her dad died, she required surgery, her mother was hospitalised and her 10-year-old son Jack sustained an injury requiring surgery, not surprisingly she was looking forward to her first family holiday since last year, to Italy. 

‘My nine-year-old daughter Lizzie is also in remission from leukaemia, and she will be followed up until she is 21 years old, so the worry of relapse is always there,’ Dr Kelly wrote on Facebook. 

‘And I have an 18-month-old, Katie-Mae, who requires lots of care which isn’t always possible due to me working 60-plus hours per week. So to say I was looking forward to this holiday is an understatement,’ she added.

Dr Kelly managed to secure a locum, until the locum realised her medical insurance and registration would run out when she had one day of cover remaining. ‘She was told she would have to renew for a full year, which would cost several thousand euro,’ said Dr Kelly. 

Despite exhaustive efforts, Dr Kelly was unable to find cover, and made the difficult decision to close the practice for a day.  On the day of the closure, she received calls every 30 to 60 minutes from her practice manager and front office team, who were manning the phones relaying her guidance to patients.

While still on holiday, she also received an email from the HSE primary care unit asking her to explain her decision to close. ‘Ironically, one of the HSE staff who was cc’d on the email I sent, returned an automated response to say that they were on annual leave until July 10th!’

This week West Cork TD Deputy Chistopher O’Sullivan is raising the GP staffing crisis with Health Minister Stephen Donnelly.

‘There is a serious shortage of GPs right throughout Ireland and we’ve been particularly hit here in West Cork to the point where, disgracefully, GPs are afraid to take holidays because it might force them to close their practice,’ Deputy O’Sullivan said.

‘The situation seems to be getting worse … Frankly the absence of sufficient GP coverage poses a significant risk to public health, and leaves vulnerable communities without accessible primary care services.’

Ironically, the news comes as the government this week announced the introduction of free GP care for around 78,000 children from next month.

Dr Kelly highlighted the service she has given to the HSE for over 14 years. 

‘I’m the first port of call for most people living on the Beara peninsula,’ she told The Southern Star, ‘including the large fishing community’. 

‘I’ve 1,000 medical card patients, and probably the same number of private patients. When my son was in CUH for three days, I couldn’t go and see him. As it stands, I can’t leave the peninsula from 8am on Monday until 6pm on Friday,’ she said. ‘I took five weeks’ maternity leave with Jack, four-and-a-half weeks with Lizzie, and I worked right throughout Lizzie’s battle with leukaemia. I had half a sandwich at my desk today for lunch and that’s typical.’

Dr Kelly has suggestions to alleviate the crisis.  Among Dr Kelly’s solutions are that the HSE would examine GPs’ current contracts. ‘GPs are self-employed and our contracts go back to the early 1970s and say we’re required to give 24/7, 365-days-a-year commitment to our patients, and young doctors aren’t willing to accept that. Doctors need to have protected time off,’ she said.

Dr Kelly also highlighted delays of up to one year to process applications for non-EU nationals seeking to work here. She also said better financial incentives were needed to encourage new people into the system, in rural areas. 

‘GPs in an urban practice will be able to cover for each other when someone is off. But in a single practice, it’s costly to take time off, be it sick leave, maternity leave, or annual leave.’

Finally, she said, reduced medical insurance rates should be made available to retired GPs able to work occasionally. 

‘We’re all under so much pressure and cannot cope with what’s being thrown at us. Urgent action is needed.’