Concern for patient welfare over loss of 23 Northern Ireland GP practices in five years
Concerns have been raised about the falling number of GP practices after a report revealed that every health trust in Northern Ireland has lost surgeries in the past five years.
The Western Trust has fared worst, with the number of practices falling from 57 to 48.
The situation has prompted calls for a second medical school here to specifically address the shortage.
In other regions, the Belfast Trust is down by six practices; the Northern Trust lost four; the Southern Trust lost three, and the South Eastern Trust lost one, bringing the total number of closures to 23.
Some 327 GP practices were active as of March 31 this year, compared with 350 at the same period in 2014.
The reduction comes despite the number of GPs increasing by 13% to 1,334 in the same period.
Doctors' groups say this is due to changing working patterns, including the number of doctors who opt to go part-time.
Consequently, the average number of patients registered per practice has increased over the same period by 11% to 6,084.
The figures are contained in the family practitioner services statistics released by the Department of Health yesterday.
Dr Alan Stout, chairman of British Medical Association (BMA) Northern Ireland's GP committee, said the figures come as no surprise.
"The BMA GP committee has been working with GP practices right across Northern Ireland and we know that while GP numbers are going up, the number of surgeries is going down," he said.
"This is because practices are having to merge and pool their resources to deal with the increase in patient numbers and the shortage of GPs.
"While the numbers of GPs are going up, we are also seeing a shift in the working patterns of GPs, with many choosing to work part-time or as portfolio GPs - a role where they may also work in a hospital or other care setting.
"This often is a good thing, as it ensures we retain them in general practice.
"Unfortunately, what these closures and mergers mean for patients is that they might have to travel a bit further to get to the surgery, but in all cases we are trying to maintain GP services to all patients."
Dr Stout said that there is a range of measures which the doctors' union would like to see implemented to address the problem, including a second medical school in Northern Ireland to train more doctors and particularly help with recruitment in the west, where it has been problematic.
The BMA would also like to see "the multidisciplinary approach to primary care rolled out across Northern Ireland", adding that it "will also continue to work with the health board and the department to remove barriers such as premises, which can prevent young doctors taking up a partnership".
SDLP health spokesman Mark H Durkan said that the reduction in practices west of the Bann presents a big challenge.
The Foyle MLA suggested proceeding with a graduate entry medical School at Magee, which would create "a steady supply of qualified medical professionals with experience in the communities most in need".
"The figures paint a picture of reduced GP services in communities across the North serving greater numbers of patients. That raises very serious challenges around sustainability, staff workloads and access to services," Mr Durkan said.
"The problem is particularly pronounced in communities west of the Bann where we know there has been a significant challenge around retaining GPs and sustaining practices.
"Worryingly, despite an increase in the overall number of GPs, the areas where we've seen a reduction in practices have been the least able to recruit new doctors, creating a downward spiral in service provision."
Alliance health spokeswoman Paula Bradshaw said that while the overall increase in the number of GPs is to be welcomed, the drop in the number of practices is a worry.
"One of the mechanisms for addressing this would be the introduction of the graduate medical school in the north west, a proposal that is failing to get any real traction in the absence of a functioning Executive despite the efforts of Ulster University and others," she said.
Last month Dr Grainne Doran of the Royal College of GPs Northern Ireland said that more family doctors are choosing to work part-time.
"We have had an increase in the total number of GPs but unfortunately they are not all choosing to work full-time in GP practices," she told the BBC.
"Instead, they are expanding their portfolios in other areas, which is great, but doesn't mean we have enough GPs working in surgeries to meet the needs of a growing population.
"For instance, they are working in emergency departments perhaps one night a week, and they are also involved in hospice care, even involved in training."
The report also reveals that women now make up the majority of GPs, accounting for 56%, as opposed to 2014 when the majority (54%) were male.