The decision by the “No Doctor, No Village” campaign to run a candidate in the forthcoming general election in the Clare constituency reflects a deep seated unease within rural communities. Villages throughout the Republic have seen local post offices, shops and public transport links closed. General Practitioner (GP) surgeries are now under threat.
Dr Michael Harty, a GP in Kilmihil, Co Clare for 32 years, who will run as an independent candidate, says practices such as his are no longer financially viable. This follows cuts in grants and allowances to all family doctors but with the added sting for many rural GPs of the loss of the long-established rural practice allowance (RPA). The amount of this annual grant has been reduced by 20 per cent; but the real blow to viability for many medical practices is the non-renewal of the RPA when an incumbent retires.
Up to 25 rural practices now have no doctor; many posts have been readvertised a number of times; on each occasion it has become clear to candidates that repeated austerity cuts to grants mean the practices are simply not viable. Some incumbents have had no choice but to emigrate and one rural doctor travels to Scotland to work for one weekend a month in order to subsidise his loss-making practice at home. And with about 900 GPs planning to retire or emigrate in the next five years, the number of villages with no doctor is set to increase.
With little response from sitting TDs, communities in Mayo, Galway, Donegal, Wexford and Tipperary are considering putting forward candidates under the 'No Doctor, No Village' banner. A recent proposal by Minister for Health Leo Varadkar to extend RPA allowances appears unlikely to derail their plans. Negotiations are continuing between the Irish Medical Organisation and the Department of Health but it will take a more deep rooted approach to the needs of rural healthcare to solve this issue. The Clare constituency unexpectedly elected a doctor, Moosajee Bhamjee, to represent its interests in 1992; such is the strength of feeling that it may do so again.