Conor D McGuinness warns of GP crisis in rural Ireland
Conor D McGuinness spoke about mounting shortages in GP services and primary care, saying the model is under real strain and successive governments have failed to plan properly. He argued for urgent reforms, proposing an increase in GP training places and expansion of multidisciplinary primary care teams.
Primary care under strain
GPs remain the gateway to the health system but the traditional model of a family doctor rooted in every town and village is under pressure, particularly in rural Ireland. The speaker emphasised that primary care is the foundation of long-term, continuous care from cradle to grave and warned that the situation is moving "well in the wrong direction."
Local impacts in County Waterford
The speech highlighted concrete local effects in County Waterford with examples from Dungarvan, Port Law and Lismore. Residents in Dungarvan struggle to get timely appointments, Port Law has restricted weekday access and the primary care centre in Lismore is delayed and back to the drawing board, creating additional travel burdens for older people and people with disabilities.
Workforce numbers and warnings
McGuinness cited historical warnings and recent statistics, noting the 2001 Future Together report flagged GP shortages and that 25 years later numbers have barely improved. He said the number of practising GPs fell from 4,583 in 2019 to 4,420 in 2022, one in four GPs are over 60, and only one in five practices are open to new public patients, signalling another looming crisis.
Policy proposals from the speaker
He proposed increasing GP training places from 350 to 450, lifting the recruitment cap for frontline roles and expanding multidisciplinary primary care teams. The speaker argued these steps would ease pressure on practices and reduce the burden on GPs who are increasingly expected to run complex small and medium enterprises while providing frontline care.
Case for investment in primary care
McGuinness stressed that the strain on GPs is not their fault but a failure of government planning and resourcing, including low levels of practice-based staff compared with comparable countries. He said investing in primary care is efficient and likely the best way to spend money in the health service, and insisted that if the government is serious about rural Ireland, GP access must be available in every town and village.
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There was a time when every town and village had its family doctor, they were rooted in the community, they were known to everybody, known across generations and today that model is under real strain in urban areas but particularly in rural Ireland. GPs as we know are the anchor of our health system, they're the gateway into our health system in most cases to provide long-term continuous care from cradle to grave, yet successive governments have failed to plan properly for primary care. In 2001 the Future Together report warned about shortages in GP numbers and practice-based staff and 25 years later we're still playing catch-up. The rate of GPs per head has barely improved in that time and is now moving well in the wrong direction and the number of practicing GPs fell from 4,583 in 2019 to 4,420 in 2022. One in four are over 60 so there's another crisis coming, Minister, and only one in five practices are open to new public patients. In County Waterford the impact is really clear. In Dungarvan people struggle to secure timely appointments, in Port Law access is restricted during the week and there's no full-time availability. As has been mentioned, the issue in Lismore, the primary care centre that's now delayed, back to the drawing board, back to the starting blocks, through no fault of the people of Lismore, through no fault of anybody practicing medicine. And government needs to get to grips with that and they need to expedite that process now. Across villages and country areas, older people and people with disabilities are travelling well behind their own communities for routine care. And that's creating an additional burden, an additional barrier for people in Dungarvan, for example, having to travel a couple of towns away. And it's simply not sustainable. So we have to be clear as well, GPs work exceptionally hard, they're dedicated and committed, and none of this is at their door, Minister. It's very clearly at the door of government. They're under huge pressure, they're operating with the lowest levels of practice-based staff in comparable countries, and increasingly they're expected to run complex, small, medium enterprises while trying to provide frontline care. And as Deputy Cullinan has said, those GPs that we're talking to, be they here in Ireland or abroad, they're telling us, well, we don't want to be entrepreneurs. We don't want to run businesses, by and large. We want to provide care. That's what they studied. And one of them said to me, if I wanted to run a business, I'd have done an MBA, not a medical course. So our approach is really straightforward. We'd increase GP training places from 350 to 450. We would lift the recruitment cap for frontline roles and expand the multidisciplinary primary care teams. Because investing in primary care is efficient. It's probably the best way to spend money in the health service. So we're first serious about rural Ireland, then access to GP care must be available in every town and every village.
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