As many as 22 GP practices in Northern Ireland are at risk of closure due to increased demand and loss of doctors, the country’s most senior GP has warned.
BMA NI council chair Dr Tom Black told Pulse that the Department of Health’s ‘crisis team’ is now looking after 22 practices which are on the brink of having to hand back their contracts.
He said: ‘The Department of Health set up a crisis team about four or five years ago to look after practices that were very vulnerable.
‘They move in and try and apply as much in the way of locums or multidisciplinary teams as they can to prevent collapses.’
But he said that it is nearly impossible to find locums.
‘In my own practice, I’ve seen one locum for one day in the last 11 months, which is extraordinary.’
Dr Black said: ‘I think a number of them [the 22 practices in crisis] will hand their contracts back, but we don’t know how many, and the more help we get them, the fewer it will be.’
Meanwhile, speaking on BBC Good Morning Ulster, Dr Black said that the extra workload of looking after patients on the elective care waiting list has pushed some GPs into early retirement.
He said: ‘That workload in addition to the usual workload that GPs do has just accumulated into this situation, where practices are closing.’
Dr Black said there has been a 50% increase in retirements of doctors in the UK, also partly due to issues with GP pensions.
He explained: ‘That’s because of perverse taxation arrangements, such that if you stayed on, you would attract huge tax bills.’
Stakeholders have been unable to find replacement GP partners to take over practices in crisis, meaning some are being taken over by local trusts.
On the Dromore and Trillick GP practice which has recently handed back it’s contract, Dr Black said: ‘It couldn’t find anyone to take on the contract. We tried very hard through usual channels to find a contractor… and it failed. So the Western Trust has taken it over.’
He said this was ‘not an ideal arrangement’ because the trust ‘also has the problem of where to find enough GPs and nurses to run the practice’.
He added: ‘And the primary practice in Belfast is so big, it’s too big to fail. It’s also too big to disperse the patients among neighbouring practices because then you’ll create a domino effect and bring down other practices.
‘They have six months before the present practice leaves the contract, so they have time to look for an alternative contractor, but it may well fall to the local Health and Social Care Trust to run that practice.’
Last week, the GPs running Priory Surgery and Springhill Surgery in Holywood and Bangor, which provide GP services for 14,525 patients, announced they would be handing back their contract next year.
In an update on the practice’s website, the GP partners said: ‘The current GP partners at Priory Surgery (including Springhill Surgery) will no longer be providing General Medical Services from 1st February 2023.
‘The Strategic Planning and Performance Group (which replaced the former Health and Social Care Board) are seeking a replacement GP contractor or a group of GP’s to provide General Medical Services to the patients currently on our practice list.’
Locum rates of £1,000 per day were recently reported in Northern Ireland.
The Irish News reported in June that the Northern Ireland Department of Health offered GPs the fee to provide cover for two daily sessions on dates in July and August at a rural Co Tyrone practice facing a staffing ‘crisis’.
It said this is ‘more than double the standard rate of £440 per day’.