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GPs go forth

13 GP practices to close in single county

Exclusive Plans are underway to close 13 of the 18 GP practices in Fermanagh, Northern Ireland, leaving patients having to travel '30 to 40 miles' to see their GP, the GPC has warned.

The proposals are under development with two practices already having closed recently, and four more closing in the next few months.

This is worse than had been previously feared, when it was reported that a third of the practices in the county would close, due to the retirement of potentially a third of the 66 GPs in the rural region.

With no GPs available to fill the slots, it has been predicted that three-quarters of Fermanagh’s practices will close within five years.

It comes as Pulse has reported that the Northern Ireland GPC will ask practices to quit the NHS in the New Year as the situation in Northern Ireland has reached a critical point in recent months with the threat of whole towns losing their GPs and out of hours services failing to provide proper cover.

Dr Tom Black, chair of the Northern Ireland GPC, said the situation in Fermanagh is even worse than other counties in Northern Ireland.

He said: 'We are trying to consolidate 18 practices into five so there will be five practices across the whole county.

‘Patients will be travelling 30 to 40 miles to see their GP. There will be an effort to maintain some of the practices as branch surgeries but it is very difficult as there are no GPs.’

Dr Black said the move to just five practices would be a gradual process.

‘We are already down from 18 to 16 and three or four more will close in the next few months,’ he said. ‘The practices want us to find them more GPs and more district nurses but they are in very short supply.’

He added that despite dire shortages across the country, there was an argument that Fermanagh was in greatest need and more needed to be done to attract GPs to the region.

‘We’re hoping over the next few months to bring in practice pharmacists, but getting more GPs and nurses will take much longer.’

Fermanagh has faced particular problems with recruiting new GPs to take over single-handed rural practices.

The GPC had previously said the staffing crisis in the region had ‘caught them unawares’ as many of the GPs were older and retiring at the same time.

A spokesperson for the Northern Ireland Health and Social Care Board said: 'The Health and Social Care Board is continuing to work with GP practices in the Fermanagh area and to encourage them to form larger partnerships so that practices are in a stronger position to attract more GPs into the area and continue to provide general medical services to residents in the long term.

'Discussions are currently ongoing with two groups of GP practices which will ensure services continue to be provided to patients in their own surgeries.

'The Board believes that the way forward for a sustainable model for provision of GP services in the area is through the formation of such networks, which would provide both high quality clinical care and an attractive proposition for young newly qualified GPs to come and work in the rural Fermanagh area.'

Pulse has been calling for emergency support to be made available to preserve practices on the brink through its Stop Practice Closures campaign.

Picture credit: Fermanagh Lakelands

Readers' comments (23)

  • "encourage them to form larger partnerships so that practices are in a stronger position to attract more GPs into the area"

    So federations are attractive to young GPs.


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  • Pay them and they will come.

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  • More nonsense. GP practices with small uneconomic lists of patients are liable to close because the income is unsuitable for replacement GPs to apply for these practices when vacancies occur. It would be better if the Commissioner offered large practices money for an additional partner to share work at the main surgery and to staff the small branch surgery. Offering the larger practice nice up to date premises for the branch practice would help. the Board are talking a lot of flannel about providing high quality care. It cannot be provided without investment.

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  • Paul, thank you for your insight!
    So you advocate a different funding model for "large" practices to add partners?
    I think m'learned friends would enjoy that!
    Oh, and "nice up to date premises" also for larger practices "would help".
    Do new buildings create qualified GPs??
    Your comment shows little understanding of how things actually work or are working.

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  • Simple. The DOH has planned this and wanted this to happen. They do not care one jot if patients have GPs or not. If you value something you feed and nurture. If you want something to wither and die you starve it.
    So, just cut funding year on year, pile on more work and everyone who is sane will leave.
    Easy. Funding has been cut by 50% to 5.5% [was 11] and workloads have gone up 50% [ consultations up from 4 to 6 ], all in about 10 years.
    GPs see 90% of all NHS consults on 5.5% and they want more work done in the community.
    Well, I know we GPs are a thick lot, but even we can see this writing on the wall.
    It is the DOH plan, so people have to take out private insurance.

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  • I was born in Fermanagh and love the county...... I always dreamed I'd live and work there one day...... I still love the place and would love to go back but there is simply no way I'd return to the NHS in Northern Ireland doing general practice. However, if there's anyone from the health board reading (Though I doubt it) If you can match the T+Cs of Australia then give me a call! (Im not holding my breath)

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  • With patients when we reach a certain point, we know further intervention is futile. Is General practice now Palliative in Fermanagh? Perhaps we need to just quietly walk away and let the patients and politicians figure it out. Let them work out what we were worth..... I really do think we need to let the system implode as long term there is more suffering keeping the current system alive

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  • Mr Mephisto

    "The Health and Social Care Board is continuing to work with GP practices in the Fermanagh area and to encourage them to form larger partnerships so that practices are in a stronger position to attract more GPs into the area and continue to provide general medical services to residents in the long term".

    Good luck with that one our “Inglorious Political Masters”.

    The HSCB are useless. They literally could not organise a p*ss up in a brewery. They have no useful advice. No helpful guidance. No resources to offer - nothing absolutely nothing. They seem to be unwilling or unable to help.

    If I worked for the HSCB I would be frankly embarrassed and shamed by my powerlessness and inability to help offering nothing more than “tea and sympathy”.

    I am not sure if the HSCB’s “Inglorious Political Masters” have truly taken on board the fact that the service is on the point of collapse.

    I am being favourable to the politicians as given the current health ministers socialist political background unlike Jeremy Hunt I doubt that she wants to collapse the NHS on purpose.

    The current health minister may not have been the one who steered the ship into the iceberg however she is at the wheel now and the ship is sinking.

    If the ship does sink then she will always be remembered as the one in charge when the ship sank.

    Just as Tony Blair will always be remembered for The Iraq War the current health minister will be remembered for allowing the NHS to sink on her watch.

    It is ironic that Tony Blair’s great political achievement “The Good Friday Agreement” was borne out on these shores however his political reputation has been destroyed by the toxic legacy of Iraq.

    There may be a learning lesson for the health minister here – you will always be remembered for your political failures not your political successes and all ultimately all political careers end in disaster

    It is ironic that the Titanic was built in Belfast and we have another Titanic melodrama playing out in our health service.

    The ship is sinking and there are not enough lifeboats to save everyone.

    Knowing how our political system works in Northern Ireland (deaf dumb and blind as opposed to Westminster’s severe case of myopia) as the Titanic finally sinks under the waves we will have a prayer meeting led by the Rev William McCrea where the whole Northern Ireland Assembly can hold hands and sing “Abide with me” whilst hoping for some kind of deliverance for a higher power – unfortunately Westminster can bail them out this time – you are on your own you “Inglorious Political Masters”

    Perhaps a more appropriate song would be Joni Mitchell’s Big Yellow Taxi - “ Don't it always seem to go
    That you don't know what you got 'til it's gone, They paved paradise and put up a parking lot”

    They will miss us when we are gone!

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  • Mr Mephisto

    What about Portadown - will it be next?

    Portexit anyone?

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  • Hey Dr Mephisto, theres a job in St Helens Tasmania (2000 people roughly, great fishing, great climate) going....packaged up over £200k/Yr... we could be neighbours?

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  • Mr Mephisto

    @Anonymous 1:04pm

    Where do I apply?

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  • If Tom Black is reading this, I suggest seriously picking up the phone to the Canadian Authorities to see what package they would offer for transferring the skills of Northern Ireland GPs en masse, as there are several areas of Canada where this would make a significant impact as well as allowing Northern Ireland Gps a strong cohort for support across the pond. The Canadians have 4 million citizens without GPs. I would then present the results of this enquiry to the local GPs for comparison and consideration. Flights are cheaper out of Dublin.

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  • Dr Mephisto..... its kinda like Fermanagh, but more salty :-)

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  • how can the aging of the gps have taken the gpc unawares?-do folk in NI not all age at the same rate as everyone else?

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  • i'm getting confused now - is this a good thing or bad thing?

    on the one hand we are told by the doh that practices come and go, moving to working at scale, more money than ever is going to be spent and the CQC basically implies small is bad BUT on the other hand we are told local services, named GP, continuity is good.

    I've given up now and am pinning hopes on NI GPs doing the right thing and leaving their contracts as this will send the right signal to politicians, the media, the public, and the medical leadership to start taking their responsibilities seriously.

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  • As one of the remaining Fermanagh GPs actually still in post (yes there are a few of us left here), I cannot understand how things have been let to get so very bad, even me, born and bred and working in the county for 25 years as a GP have looked at the possibility of escape to a new life down under! says it all really, I cant see it getting much better any time soon and as Rome burns, Nero happily fiddles away to the same old tune in Stormont, endlessly bailing out secondary care from the deepening financial hole that they are digging themselves into............

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  • Never too late Mark!!!! Go Go Go

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  • I agree mark..go
    this government does not deserve you.

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  • Go soon before Auz closes the doors to gps. At least you will have a head start on the rest of the UK.

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  • Mr Mephisto

    @ Mark Cathcart Dec 2016 5:19pm

    Hi Mark. Shocked and horrified to hear of what has been allowed to happen in Fermanagh. It has been an absolute disgrace. I’m surprised there has not been any public anger on the issue. The politicians don’t give a sh*te what happens in rural Fermanagh, West Tyrone, or South Armagh which have been literally left to die. If it doesn’t happen within shouting distance of the Reichstag (Stormont) they don’t care. They did get very interested about the closure of one single handed practice in Bangor. However Bangor is much more important that the whole of County Fermanagh, Armagh, Tyrone etc… The BBC have been completely silent on the issue. This speaks volumes about the quality of their journalism which is low level “TV personality” sh*te and completely Belfast focused. Unless the issue directly affectes the “Belfast Metropolitan Elite” (I use this phrase tongue in cheek) then the issue does not exist. It will not get any news coverage from the BBC unless Marie Louise Connelly, Mark Carruthers or Frank Mitchell can’t get a GP appointment. The crisis will hit Belfast soon enough. By that time it will be too late for all “non-Belfast” GP land.

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