General practice is in a critical condition
There is an undoubted crisis growing in primary health care, as our report today graphically illustrates. The number of full-time GPs in Northern Ireland stands at 950 - less than in the 1950s -and around a quarter of those are likely to retire within the next few years.
Although it was not explicitly spelled out to MLAs yesterday by the GPs' representative body, the BMA, it is clear the profession is having difficulty recruiting new doctors. Most, it seems, prefer to take their skills and knowledge into a hospital setting.
GPs are the gatekeepers of the health service. They are the point of first referral for the vast majority of people, and the decrease in numbers, allied to the increasing age of the population, means pressure on them is growing.
The BMA says doctors are expected to conduct 43 consultations a day. On the basis of what can be a short time with patients, they are asked to make potentially life-or-death decisions. Certainly, that is a pressured profession.
The problems of primary health care have been repeatedly highlighted by the BMA. In June this year, the body set out its vision of the how the crisis could be tackled. Recommendations included more investment (up to 10% of the health budget on an annual basis), a reduction in the bureaucracy GPs face, a taskforce to help under-pressure doctors and practices, and plans to recruit more young doctors into general practice.
The BMA says that failure to act could result in a decimation of services in areas such as Fermanagh, where the number of practices could fall from 17 to five, with patients having to travel up to 40 miles for an appointment.
If the BMA's doomsday predictions come to pass, that will present huge problems for patients. Already it is very difficult in most practices to get a GP appointment, often taking days or weeks.
That has led to many people going directly to A&E hospital departments, heaping further pressure on another strained sector of the NHS.
Getting a house call from a doctor, which not so many years ago was a common enough practice, is now nearly impossible, and at weekends patients have to go to out-of-hours services, which can be located well away from their normal practice.
The concerns of the BMA need to be heeded, and the Department of Health must work closely with the medical profession to set up a sustainable model of general practice.