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Dr Michael Smyth has described how his patients appear to spend years 'revolving around' the NHS in Northern Ireland because of huge waiting lists.

Dr Smyth, a GP in Maguiresbridge, Co. Fermanagh, said patients 'return and return' to his practice when they should have been well on their way down a referral pathway. Some had waited months for breast clinics, even when if they had suspect lumps.

Such waits had a detrimental effect on both patient health and GP morale, he said. 'You feel you are working in a system where you know what has to be done but you can't get it done,' he said.

'You think you have it sorted and have referred appropriately but they keep bouncing back. Patients seem to revolve around.'

Dr Smyth said GPs appreciated that the NHS in Northern Ireland was inefficient, but added that, contrary to the Appleby report's conclusions, it had been underfunded for many years.

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