HSE pulls plug on Saturday morning GPs

A CLONAKILTY GP has said several towns in West Cork are in danger of having no Saturday morning medical cover, as the HSE has, effectively, closed the clinics, having not paid doctors for the work since last July.

Dr Oriel Perrott told The Southern Star this week that doctors get paid a couple of months in arrears for the Saturday morning clinics, but they have not received any payment now since July, as the HSE says it is no longer covering those clinics.

She says doctors operating the service in several towns including Clonakilty, Skibbereen, Rosscarbery, Enniskeane, and Kinsale noticed recently that they had not been paid for several months, but had not received any advance warning. ‘They did this without any consultation with us,’ she said.

She says the situation seems to have arisen because the Primary Care Reimbursement Service (PCRS), which covers the scheme, appears to be saying that SouthDoc should be covering those hours, but SouthDoc does not provide cover in Clonakilty, for example, until 1pm on a Saturday.

‘We are caught in the middle and, like fools, we are working away, but nobody is listening to us,’ said a very angry Dr Perrott. The consequences for the patient are very serious, she added.

The doctor, who has worked in Clonakilty for 17 years, says she has continued to keep her doors open because in conscience, she couldn’t turn anyone away.

She cannot discriminate against public patients and only open the door for those able to pay for the service, she said.

‘We pride ourselves in the fact that we have always had private and public patients sitting side-by-side in our waiting room, getting the service, with no difference in waiting time or the treatment they receive. The HSE is effectively suggesting we only take private patients on Saturday mornings. I live in this town, I couldn’t have it on my conscience if I closed my door to a public patient and it led to a bad outcome for them. I asked them, if I had a two-and-a-half year old with a fever, what am I to do with them, but they had no answer for me.’

Dr Ivan Martin from the Medical Centre in Rosscarbery said the clinic is very busy Monday to Friday but added: ‘We believe it is necessary to have an emergency service available to our patients on Saturday mornings. This acts as a pressure release valve because it allows us to treat patients with acute and urgent medical conditions. While SouthDoc provides an excellent out-of-hours emergency service, the closing of the Saturday clinics will pile further pressure on the already stretched Southdoc service.’

He also made the point that the patient’s own GP is most familiar with their medical condition and their needs.

‘SouthDoc is more likely to direct patients towards an already overstretched ambulance service, as well as the accident and emergency departments,’ he suggested.

Dr Martin believes the closure of Saturday clinics will put pressure on ‘an already overburdened Monday to Friday schedule, and could also lead to a deterioration of community-based care.’

At the moment, if Dr Perrott was to withdraw the service, it would mean that patients needing urgent care would be left with no option but to make their own way to a hospital, rather than get local GP treatment. ‘And that assumes they have a car at their disposal,’ she said.

‘And then they wonder why the A&Es are full, and they cannot recruit GPs?’ she asked. ‘But it’s getting to the stage where it’s just not feasible for me to open.’

She added: ‘I am very loathe to go public on this, but I have tried to get something done, and I really feel like nobody is listening. And the bottom line in all this is that the patient will not have a service on a Saturday morning if this continues. We are endeavouring to find a solution but until then, we are effectively unable to open our doors on a Saturday morning.’

Dr Perrott says the only options are to work for free on Saturdays or close the clinics for all, putting extra pressure on emergency departments in city hospitals.

Ironically, this week Cork University Hospital said its Emergency Department was exceptionally busy and some patients may experience a delay.

Where appropriate, it said, the public should contact their GP/SouthDoc in the first instance and explore all other options available to them prior to attending the Emergency Department if their needs are not urgent.

At time of going to press, there was no comment available from the HSE or the Irish Medical Organisation, despite several contacts made.