GP Housecalls on GMS

Doctors threaten to end house call-outs

By Catherine Shanahan

Monday, May 02, 2011

THE era of the familydoctor making out-of-hours house calls could become a thing of the past because of a halving of the fee paid to GPs to make the trip, doctors warned at the weekend.

The fee reduction, from €93.24 to €45, took effect after the December Budget and is threatening the viability of general practice in rural areas, according to members of the Irish Medical Organisation (IMO).

It could also push up the number of patients attending emergency departments if doctors choose to reduce the number of house calls they make on foot of the cut in fees.

Speaking at the IMO’s annual general meeting, Mayo-based GP Dr Ken Egan said he had been called out to fires and “to all kinds of local stuff” because it would take an ambulance 30 minutes to travel from Galway to where he is based in Ballindine, between Claremorris and Tuam.

However, in light of the fee reduction, he would be more likely to advise that patients call an ambulance “rather than driving 30 miles to see someone for €45, which is the same as what I get for seeing them out-of-hours in the surgery”.

“I’m not going to say I’m not going to see you because I’m not getting paid, but I have to think of the patient who’s coming in to me [in the surgery], and the house call I have to do and I will stay for the patient coming in.

“I have to make a living, I have to run my practice, if it’s not going to pay me, I have to look at that.”

Dublin-based GP Dr Ray Walley said the cuts were “a savage imposition on rural doctors” and could lead to greater reliance on the ambulance service, which typically costs more than €1,000 per call-out.

Dr Michael Kelleher, based in Lahinch, Co Clare, said it was going to disincentivise new blood coming into rural general practice.

“No young doctor with half a brain is going to set up where they will lose money,” he said.

Dr Aonrai Finnegan, based in Ballinasloe, Co Galway, said the house call was “a fundamental part of general practice” but its days were effectively numbered.

However, Irish Rural Link, a lobby group representing the marginalised and disadvantaged in rural areas, said patients were entitled to a service regardless of what the doctor was being paid.

Spokeswoman Helen Dunne said more than 40% of the population was living outside of the main cities, many of whom were elderly and low-income and “regardless of where they live, they should not endure any less a service”.

“If they are ill and vulnerable their needs should be protected,” she said.

Gerard Scully, spokesman for Age Action, said they hoped doctors made decisions in relation to patients on medical and not financial grounds.

It is estimated that cuts in professional fees paid to GPs introduced in December will make annual savings of €48 million.

This appeared in the printed version of the Irish Examiner Monday, May 02, 2011