Urgent care centres for children

Sir, – Part of the package of the planned new children’s hospital are two urgent care centres. As a GP with a large paediatric practice in a high-demand area, the logic for such centres is not clear to me.

If I have a child who needs urgent care, such as suspected meningitis or severe asthma, I send them to my nearest large centre, which for my practice is Our Lady’s Hospital, Crumlin. Much of the rest I manage myself like most of my colleagues in the area.

In my practice area we now have a purpose-built out-of-hours GP centre that sees many sick children, and if they are seriously ill they are also referred to Crumlin. Unless anyone tells me differently, I will send such patients to the new children’s hospital and certainly not to an urgent care centre. I expect the urgent care centres will be doing the same thing.

What we badly need in modern GP paediatrics are services for the increasing behavioural, psychological and social needs of our young patients. These services are currently underfunded and have difficulty attracting and retaining staff. They place huge stress on families, schools and communities urgent care centres will not be of much help to such patients. Such centres will need capital and ongoing finance to staff them with general paediatricians, who are thin on the ground these days.

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They will reinforce the behaviour of patients who bypass their GP and go to the hospital, which is often unnecessary. Access to such a service medicalises patients in a completely casual manner.

Additionally they will take investment away from general practice that already provides much of the care that urgent care centres will ultimately be providing.

The funding fiasco in the main children’s hospital will only extend to the urgent care centres which are poorly costed, not thought out and are not responding to the current needs of children in my practice area. They are a line-item tucked into the overall accounts which should be scrapped until they have a clear purpose and respond to the needs of families. – Yours, etc,

TOM O’DOWD, MD

Tallaght,

Dublin 24.