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Call for more GPs to be trained
[Posted: Wed 16/12/2009 by Niall Hunter, Editor www.irishhealth.com]
Ireland badly needs more GPs, and the number of doctors being trained as GPs needs to increase substantially, according to the Competition Authority.
The Authority has also welcomed a recent major loosening of restrictions on GP advertising.
The Authority, in a new report, also calls for the removal of restrictions on advertising by GPs, something that was addressed recently by the Medical Council.
The Authority's report says there are around 2,800 GPs in Ireland but the number is relatively low by international standards.
Ireland has only 60% of the number of GPs per 1,000 population compared to Germany and the US and only about two-thirds of the number of most European countries.
The report points out that due to the increased "feminisation" of general practice, with more and more women entering the profession, and a move towards earlier retirement more GPs will be required in the future simply to maintain existing levels of service provision.
It says these factors as well as rising demand for GP services, raise concerns about the adequacy of GP supply in Ireland now and in the future.
The concerns about supply are particularly significant given that the Government is aiming to increase the focus of healthcare on primary care, moving treatment away from hospital and into the community.
"An adequate supply of GPs is essential to such a strategy and also to competition in GP services."
The report proposes that instead of having to undergo a four-year training scheme, including two years' hospital training, recognition should be given in cases where a GP trainee has previously obtained hospital experience so that their training can be "fast-tracked down to two years.
The report says currently, in four year training programmes, many trainees are merely repeating certain training. It says a fast-track programme would remove a bottleneck and increase GP supply.
An alternative "fast-track" training scheme is in fact already under consideration by the HSE, following recent talks with the Irish College of General Practitioners.
The HSE last year, for budgetary reasons, decided to freeze a planned expansion in the number of GPs being trained.
The Authority's report notes that the cost of visiting a GP has risen rapidly in recent years, significantly outpacing the general rate of inflation.
It says a substantial number of private patients are delaying GP visits due to cost factors and are "shopping around" for cheaper GP fees.
The report says there are significant unnecessary restrictions on advertising by GPs and in how they can supply patients with information and removing these restrictions will benefit patients.
For example, GPs have traditionally only been allowed announce setting up a practice by way of newspaper notices. Local radio announcements, flyers and other normal methods of advertising have not been allowed.
The report also points out that advertising of prices was actively discouraged.
The report notes that the Medical Council last month removed many restrictions on advertising by doctors, which will make it easier for consumers to get information about the availability and price of GP services in their area.
The new Medical Council advertising guidelines do not place any restrictions on where a doctor can advertise or on the size of advertisement, and allows them to publish more information than previously about the services they offer, provided they do not make false claims.
The guidelines should allow doctors to promote their practices more explicitly and more widely through other media such as through flyers, on the radio or through the internet.
The new guidelines do not specifically say that GPs can advertise fee rates other than inside the surgery, but state that the fees charged should be appropriate and patients should be informed of the likely costs before the consultation and treatment.
The Competition Authority has welcomed the removal of restrictions on medical advertising.
The Irish College of GPs, responding to the report, said it welcomed the Authority's proposal for the expansion of GP training and in particular, the proposed "fast-track" training scheme.
It says it is currently in discussion with the HSE on expanding GP training places and hopes that these will be increased from the present 120 to 160 per annum from next July.
The College says the issue of how GPs inform patients of their prices needs further clarification and consideration, and it has welcomed the recent lifting of advertising restrictions.
The College's Communications Chairman Dr Mel Bates told irishhealth.com that while the new advertising guidelines needed to be clarified in areas such as advertising prices, he pointed out that most patients would not necessarily shop around for GP services in the same way they might do for petrol.
He said being able to advertise more directly would be of advantage to younger GPs trying to set up in practice.
The Authority is to publish a further report next year on the medical card GP scheme and restrictions on GPs trying to enter this scheme.
View the new Competition Authority report on GP services here
See also "Trainee GPs earning over €80,000"
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