Sir, – Recent healthcare reports have all promoted the value of decanting hospital activity into general practice and the need to resource such a workload transfer.
The reality is that general practice workload has become a lot more complex over the last two decades, and hospital support has become more patchy. However, we have maintained high standards on direct measurement of meaningful national general practice quality markers. That would include the very low proportion of undiagnosed diabetics in the community, and a continuity of care available to Irish patients that is only aspirational in countries with more corporate general practice structures. Also, the Irish emergency department attendance rate per capita is only 60 per cent of the UK rate, which would be a surrogate marker of the quality of Irish general practice. This is despite the UK general practice being funded with approximately twice the share of the national health budget compared to Ireland.
Worryingly, the increased debate about general practice over the last decade has been polluted by an exaggeration of the general practice public and private funding. Until the 2015 Healthy Ireland and separate Central Statistics Office reports on general practice workload were produced, the then-government was working off patient visiting figures that were half that general practices were experiencing.
In reality, Irish general practice funding has reduced from 4.9 per cent of the total health budget in 2000 to 3.6 per cent in the recently produced 2015 national health accounts. GPs believe that the money is certainly not following the patient, but it appears to be resourcing an increasingly bloated bureaucracy. – Yours, etc,
Dr WILLIAM BEHAN,
Walkinstown Primary
Care Centre, Dublin 12.