General Practice in
Ireland 2013- from the
perspective of training
and recently qualified GPs
by Dr Aifric Boylan
GP and member of the executive committee of the NAGP
primary care represents best value for the state
and the taxpayer
 Solution to the health service budget crisis
 High quality accessible care local to patient and
at fraction of cost of hospital treatment
 Requires well trained, properly distributed
workforce of GPs
 At present approximately 160 GPs complete
training schemes nationwide per year
 However......
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Pre-existing Shortfalls
 Low number of GPs per capita, one of the lowest
in the OECD, with approximately two thirds the
numbers of GP per capita as compared with most
European countries in 2007.
 Research by the ESRI in 2008,2009 “a profound
and worsening problem of distribution of GPs
across the country”.
 An ICGP Manpower study of just over 1000 GPs
in 2008 showed that 50% of respondents
expected to retire by 2020. Furthermore, 27% of
those doctors had closed their lists to new
patients as they were overloaded with work, and
that was before the economic collapse
Approximately 47% of Irish trained
doctors do not work in Ireland, which is
higher than all countries in the OECD.
 Nearest country to us is Luxembourg at
17%
 UK only 6%
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A survey in 2012 showed that 66% of
final medical students did not intend to
work in Irish hospitals once their intern
year was complete
Survey November 2013
 Mailing lists of training schemes , NAGP
mailing list and distributed via other
forums.
 297 respondents over 1 week

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18.5% definitely will or already have emigrated,
or plan career change

Almost 24% possibly emigrate

7% don’t know

Definite loss to system of around 18%, but up to
40% if some or all of the “possibly emigrate”
group subsequently decide to leave.
Plan to possibly emigrate is highest
amongst trainees at 49% possibly, 12%
definitely)
 < 2 yrs qualified : 12% possible , 19%
definite
 2-5 years qualified: 20% possible, 5.7%
definite
 5-10 years qualified:11% possible, 4.3%
definite

13% of GPs who are already established
as partners or principals stated they
would possibly emigrate
 Almost 5% of established
partners/principals definitely intend to
emigrate
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Major sources of stress
1: feeling undervalued by the state -68%
strongly agreed
2: feeling unfairly targeted by media- 59%
strongly agreed
3:Difficulties accessing hospital/tertiary care
for patients 50% strongly agreed
Followed by feeling overworked, feeling
underpaid, inadequate facilities, and negative
effect on social and family life
Only 14% reported stress from feeling they’d
made wrong career choice
So who are we losing?
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Summary
We are at present likely to lose at least 18% of our
high quality, newly qualified GPs, at a time when we
need these particular doctors more than ever (ageing
population, ageing GP population, and economic
imperative to divert care from hospital setting) without them primary care cannot function.
There needs to be investment in the specialty of
general practice , and primary care at large, as well
as proper incentives for doctors to work in rural or
more needy areas.
Morale is a massive issue
GPs want to be GPs, but we need support from the
state
Action needed NOW! We don’t need more studies!
Priority of NAGP to focus on this issue,and bring it to
HSE , politicians, media .