Concern over future of rural healthcare

A REPORT undertaken by the Irish College of General Practitioners (ICGP) on the future of rural general practices has revealed that further inequality of access to healthcare amongst rural populations, which has never been a feature of health care provision in Ireland, will be created if measures are not introduced to support rural general practice.

The author of the report, Dr. Margaret O’Riordan, said the ICGP has seen the emergence of an urban-rural divide in many areas of life. Running down of services from public transport to closure of post offices, shops, pubs and garda stations has left many rural communities devoid of essential services as well as opportunities for social interaction.

She stated: 'The expansion of this divide into healthcare, specifically rural general practice, is creating a systemic problem as large as the existing public-private divide in terms of access to healthcare for rural populations.

'If measures are not introduced to support rural general practice, further inequality of access to healthcare amongst rural populations, which has never been a feature of health care provision in Ireland, will be created.'

The ICGP report, entitled ‘Vision for the Future of Rural General Practice’, examined the key issues affecting rural general practice as well as making recommendations for arresting its decline.

Said Dr. O’ Riordan: 'Following consultation with ICGP members and in particular the Clare, Galway and Mayo ICGP faculties, the issues which consistently emerge as problematic are recruitment and retention, lack of infrastructural support, out of hours services and locum cover, ambulance support and pre-hospital emergency work, and professional and social isolation. The development of large primary care centres may improve access to services in densely populated areas but will not be viable in rural areas,' she said.

The report offers a range of solutions to government following examination of international best practice solutions for improving recruitment and retention of general practitioners to rural areas.

'Having considered the current challenges facing rural practice and a range of interventions that have been proven internationally, it is clear that a multifaceted approach is needed to address this issue in Irish general practice,' Dr. O’Riordan said.

'Financial incentives, like restoration of the Rural Practice Allowance and Distance Codes, while essential, will not work alone. It is clear from international experiences that one size does not fit all and that planning at a local and regional level will be needed to meet the needs of communities and patient services,' Dr. O’Riordan added.