I move amendment No. 1: To insert the following after "and investment in analytical capacity": "; further recognises that: — the inverse care law and unequal access to GPs is giving rise to stark inequalities, delayed diagnosis, poorer health outcomes, and increasing upward pressure on the hospital system; — recent extensive research by the Labour Party on GP-to-patient ratios has highlighted significant inequalities, and found that there is one GP per 1,390 of population in Clontarf in Dublin 3, yet in Cabra in Dublin 7, the ratio is one GP to 3,060 of population; — suburban areas of significant population growth are struggling with a lack of GP services, with East Meath having one General Medical Service GP for every 5,090 people, a divergence of 3,331 from the national average; and — the 2025 Economic and Social Research Institute projections, of national demand and workforce requirements for general practice in Ireland, also show there will be a demand increase of at least 23 per cent by 2040, requiring up to an additional 761 to 868 General Practice Nurses, alongside increased GP numbers; and therefore, further calls on Government to support the passage into law of the Health (Availability of General Practitioner Services) Bill 2025, to provide for a direct statutory link between the HSE's assessment of the level of need for primary care services in specific areas, and the level of service provided.". I thank Deputy Pádraig Rice and the Social Democrats for bringing forward this really important motion. This issue has been very close to my own heart for a number of years. It is something we have spent a lot of time talking about over recent years. While there has been a little bit of progress with regard to the chronic disease management programme over recent times, the fact remains that the Department of Health does not have a consistent overview of the first point of access to the healthcare system in this country, that is, the GPs. That is wrong. It is an anomaly we see in hardly any other country across the European Union but we see it in Ireland because we have a public system of hospital care and an effectively private system of GP care. The Government has been promising a strategic review of GP care for a number of years now. It was supposed to be published last year but we have yet to see it. Where is it? Will the Government please publish it? I will move onto a second key thing. At the height of our rushing through of Covid-related legislation, back in 2020, I stood in this Chamber as a Senator when the then Minister for Health, Stephen Donnelly, legislated for free GP care to be expanded to those under the age of 12. That is still not in place six years on. Billions of euro have been generated for our public finances and yet the Government has not managed to get its act together on this. Expanding access to free GP care is one thing. We in the Labour Party are passionate about it. The then Minister of State, Kathleen Lynch, introduced free GP care over ten years ago. That was the starting point. At that time, free GP care was provided for those under four or six. If we do not increase the number of GPs on the ground along with expanding universal access to GP care, which is at the core of Sláintecare and which we are passionate about, we will end up replicating the inequalities of our hospital system. People will end up paying to leapfrog the GP system. We need to make sure we have more GPs on the ground. There have been initiatives on the part of the HSE and the Department of Health such as the arrangement with South African doctors and the increase in the number of GP training places. However, it is incredible that the Department of Health still does not have a clear idea of the unmet need for GPs or a precise picture of where GPs are located across the country. Last year, my office spent six months trying to get information on the number of GPs across every community health network area from the HSE. It was shambolic. Some areas were really on the ball. Other areas did not know. It took six months to put that data together. I am delighted to hear that the Social Democrats are using that data. I am sure anybody with intellectual integrity in the party will credit the source of that data. The key thing is that the Department does not know where the unmet need is and does not have an ongoing overview of where GPs are located across the country. That is wrong. That is why we brought forward that Bill last year and why it is scandalous that the Government is now opposing our amendment, which would ensure that the HSE would take responsibility for at least looking at where GPs are located across the country. We can have all the motions in the world about the need to improve GP services but we will not ensure we have a proper number of GPs in place for the communities I represent in Dublin Central and for communities in Kildare, Limerick, Cork city and elsewhere if we do not change the legislation to ensure the HSE takes direct responsibility. The reality is that not every community is the same. The Pobal deprivation index states that people in some of the most deprived communities are four and a half times more likely to have poor health outcomes compared with the average community. Part and parcel of that is access to GPs. In the community I represent in the north inner city, there is one GP for every 3,500 people. In Cabra, there is one for every 3,000 people. In other parts of the country, it is not an issue. If you ring up to look for a GP appointment you will get one within a few days. I know of a 50-year-old woman who went to her pharmacist and was told she had shingles. She rang her GP for an emergency appointment and was told she would get one the following week. A man came to me last year who should have presented with very worrying symptoms of prostate but, because he was being given appointments two weeks out, he kept on putting it off because of work and other commitments. He should have been able to pick up the phone, say he had a problem and be seen in a timely manner. This is a real issue in certain communities, although not in every community across the country. The key thing is that, if we have more people on the ground, we can begin to resolve all of the issues we have with regard to our acute hospital system, including the Mater being the GP service for many people in the inner city because they cannot access a GP. The other key issue I will raise today has regard to the GMS scheme. It is effectively weighted towards women of child-bearing age and the older population. The national average life expectancy is about 82 but, in one GP practice in my constituency, Summerhill Family Practice, part of the GP Care For All network, it is just under 60. That speaks volumes about what is happening on the ground.

Sentiment score: 0.15