More GP Training Places Must be Made Available Immediately if Primary Care is to be Properly Rolled Out Across Tipperary-Phil Prendergast
Issued : Wednesday 10 February, 2010
There needs to be an immediate expansion of GP training places to a minimum of 150 if the target of having 542 Primary Care teams operating by the end of 2011 is to be reached, according to a report on Primary Care published by the Oireachtas Committee on Health and Children today.
Senator Phil Prendergast is a Committee member. The report analyses the progress of the implementation of the Primary Care Strategy1 since its inception in 2001 and makes a series of recommendations aimed at adding momentum to the establishment of Primary Care in Ireland. To inform the report, the Committee conducted extensive research by visiting two existing Primary Care centres in Cork and Cavan and consulted widely with agencies central to delivering Primary Care. Committee Member,Senator Phil Prendergast said; "Traditionally, in this country there has had an over-dependence on the hospital system to undertake patient care ranging from the most complex surgeries to basic diagnostic procedures. However, the Primary Care Strategy 2001 identifies local community health facilities which feature multi disciplinary teams of healthcare professionals working together as the most appropriate setting to meet up to 95% of patients’ needs. While some progress has been made2 in achieving this target, the Committee believes that because Primary Care is such a fundamental element to the reform of Health care policy in Ireland, there needs to be added impetus and drive to further the effective roll out of Primary Care services throughout the country. Key among the recommendations is the urgent need to expand GP training places from the current level to at least 150. A failure to do this is likely to increase waiting lists and put a greater burden on hospital casualty departments. The report also proposes expanding the role of nurses and pharmacists within the Primary Care Team while there will also be a need to transfer resources from the hospital to the community setting, meaning that the resources would "follow the patient." Among the report’s main recommendations are: The immediate expansion of GP training places to 150. This would incorporate an accelerated training programme, which would recognise prior training and shorten the four year GP training programme. There are currently 120 places per annum. The expansion of nurse and pharmacy delivered services to deliver a variety of new services. Community mental health services be based in Primary Care Centres There must not be a "corporatisation" in the development of new primary care infrastructure. But a system of incentives should be provided for their construction. Diagnostic facilities must be available so that tests can be carried out locally. Minor surgery services should be provided at primary care level. Primary Care settings should be of central importance to health promotion. Information Technology systems which facilitate the flow of information between hospitals and Primary Care need to be implemented. Primary Care teams should have the potential to carry out follow up colonoscopies. The necessity for an effective Primary Care system which will need additional GPs is emphasised by the projected rise in GP visits in the period up to 2021. The number of GP visits is expected to exceed 14.5 million in 2021. This year is likely to be about 12.2 million. Phil Prendergast added: A central finding of our research is that a "follow the patient" system needs to be introduced regarding healthcare funding. This would see funds diverted to primary care as it will be where patients receive more and more of their treatment. There must also be more emphasis placed on the physical structure of Primary Care teams. Our investigation has shown us that while it is valuable to have doctors, nurses and social workers all committed to working together they need to be in one single location. More prominence must be placed on providing community mental health services through primary care teams. Services such as radiology, ultrasound and cardiac diagnostics need to be available at Primary Care centres so that all tests which can be done at Primary Care level are done and that patients don’t need to travel to hospitals for these procedures. In total, our report contains 40 recommendations. We feel that this Committee’s objective scrutiny of this topic can help drive forward Primary Care in Ireland and contribute to the revolution in the way people receive their health and medical care throughout the length and breath of Ireland. In order to inform the report the Committee conducted extensive research and consulted widely with agencies and organisations central to the delivery of Primary Care services. It held public hearings with groups including the Health Service Executive, Irish Nurses’ Organisation, Irish Pharmacy Union, Irish Dental Association, Irish College of General Practitioners and the Health Information and Quality Authority. The Committee also undertook two visits to Primary Care teams in Co Cavan and Cork. The report is entitled "Primary Medical Care in the Community".
