The lack of communication between Irish GPs and medical specialists is the biggest problem in the health service today, according to an Irish GP speaking at the WONCA conference.
The State's health system was "creaking and about to fall apart on communication issues alone," said Dr Peter Wahlrab, who practises in Kells, Co Meath. He described what he perceived as a "lack of respect on both sides", especially in the Republic's "very hospital-based health system". It was a service for the providers, not the patients, he said.
If a patient was referred to a hospital, "it's up to the GP to speak to the specialist to prioritise the patient against other patients". But, he asked, "how do you prioritise your patient against another one? It's not equitable".
Dr Wahlrab was taking part in a workshop on improving communications between GPs and specialists. English, Canadian and Scandinavian doctors presented their experience of this issue and delegates took part by identifying common problems and trying to find solutions.
The main problem identified by the workshop was the lack of respect and communication between specialists and GPs. "There's a worldwide tradition that the bulk of medical education takes place in hospitals. There is a tendency for specialists not to understand the work of GPs. GPs tend to be put down," said Dr Iona Heath, who practises in Kentish Town, London.
The workshop consensus was that there was a lack of patient-centred communication. Dr Brent Kvern from Canada cited one case where a patient was in hospital for 45 days before he heard about it.
Dr Wahlrab said the "interests of the patients should come first", but this was not happening in many cases. Sometimes money came first. A New Zealand participant in the workshop had described the patient as a "revenue-gathering unit", he said. Hospitals were also competing for their funding so that sometimes patients did not get the services they needed.