Fewer Doctors on Call following funding cut of 65%

Since last Friday, July 1, only three GPs have been on duty after 10pm in the North East Doc On Call Service despite the fact that for over 10 years there were four - one for each of the counties covered by NEDOC: Cavan, Monaghan, Meath and Louth. GPs have been force to drop the fourth doctor and reorganise the territories, following a cut of more than 65% in funding from the HSE last March. Up until Friday, the GPs had been subsidising the cost of providing the fourth duty doctor after 10pm, while calling on the HSE to reconsider its decision to fund the fourth GP. The cut now means that NEDOC can no longer guarantee that there will be a doctor in the Cavan or Castleblayney centres after 9.45pm. Speaking to The Anglo-Celt this week, Dr Dara Hume of Drumalee Family Practice in Cavan, one of the doctors rostered to cover the out of hours service in Cavan, said that this was a huge "disappointment" and very "frustrating" for the doctors who provide the service. "We have provided a superb service for 10 years. Then suddenly bang, they drop our funding by 67%," she said. "We want to provide the best possible service to our patients both in and out of hours and this massive funding cuts shows that the HSE obviously don't value what we do," added Dr Hume. Established in September 2000, NEDOC provides an urgent GP service to 350,000 patients in Louth, Meath, Cavan and Monaghan. Until last week, the four doctors operated after 10pm within their county boundaries and some 35 GPs in County Cavan had a rota system in place whereby they covered about one shift per month. Now, one doctor will cover the north, one the east and one the south. The north night duty doctor will work from Monaghan town to cover south to Virginia and Carrickmacross, while the doctor in the east will cover calls from Balbriggan to Carrickmacross, and the doctor in the south will cover calls from Dunboyne to Virginia. GPs in the north east region have questioned the funding cut and are raising concerns that the service will not now operate safely or effectively. They demand that the HSE review its decision. Cavan GPs met last week to discuss the effect of the cuts. Following the meeting Arlene Fitzsimons, operations manager of North East Doctor on Call, explained that had GP hours been cut in line with the 65% reduction in income, the NEDOC service would have collapsed completely. "Since March of this year the service has been subsidised by GPs who have taken a number of cuts to their rate of pay. They have also contributed to the funding of the night duty doctor through the NEDOC company which represents GPs," said Ms Fitzsimons. "For the past ten years four doctors have been on duty in the region after midnight. We requested support from the HSE to maintain this level of rostering at night and proposed that GPs would cover the cost of two night duty doctors and the HSE would also cover the cost of two." She claims that they were informed by the HSE during a number of meetings that it does not consider the number of calls after midnight merits four doctors at night. However, GPs in the region believe the geographic region does merit four. "Night duty (red eye) doctors regularly deal with an overflow of patients from earlier sessions. The unpredictability of where and when calls will come in can cause problems for doctors trying to cover a large rural area," explains Ms Fitzsimons. The cuts to the NEDOC service coincided with the HSE decision to outsource triage to a nurse triage company rather than to maintain the doctor advice system. The Board of Directors of NEDOC Ltd, representing GPs, strongly objected to this change to the service but to no avail. Dr Daragh O'Neill, chairman of NEDOC, said that since March, home visits have sky rocketed by 75%. "With the change of GP rostering levels we cannot continue to have doctors sent on unnecessary home visits. A doctor can only be in one place at a time and if a doctor is in the treatment centre, then he/she cannot go on home visits. We are asking the HSE to be aware of this when liaising with the nurse triage company, in order that the workload is managed appropriately," he said. Doctors are now worried that patients will not have access to the services that they need and they will now have to go to A&E instead of contacting NEDOC.