We are sick of saying 'Sorry'..

GPs are sick of saying sorry


Why are GPs protesting outside The Dail on Wednesday next?


In short, because we are fed up being at the frontline of our dysfunctional health service and are sick of saying sorry to patients for all the things we can’t provide but are expected to.......

GPs are sick of saying sorry

Why are GPs protesting outside The Dail on Wednesday next?

In short, because we are fed up being at the frontline of our dysfunctional health service and are sick of saying sorry to patients for all the things we can't provide but are expected to.

In order for General Practice to continue to deliver a service that the people of Ireland deserve it is critical that we have appropriate resources along with access to local services for patients as required.

Most of the Irish population depends on General Practice as the main access point to the entire health service, with the majority of first contacts with the health service occuring in our consultation rooms.
We can solve most problems if resourced to do so.

With the dwindling number of GPs delivering this service too stressed, burnt-out, starved of staff and access to supports for patients, the entire GP system is on the verge of collapse.
Already 70% of practices are closed to new patients, dozens of communities are now without a GP, with waiting lists in many areas for appts.
If your family can no longer access a good GP service, what is the alternative?

An overcrowded A&E in a hospital 60 miles away?

A private hospital that might be closer but certainly isn't cheaper?

Political decisions created this problem, and it is now down to politicians to fix it.

FEMPI (Financial Emergency Measure in the Public Interest) cuts of 38% were imposed on General Practice including staff and expenses since 2008, and have not been reversed despite the crisis being over.

This was not a cut to GP wages. These cuts were gross cuts to resources.

Politicians, who suffered lesser cuts, decided to reverse FEMPI for themselves (along with a pay rise, for no extra productivity) and almost everyone else, but left General Practice starved of resources with spiralling demands, an inequity which is hard to fathom.

As a result, hundreds of GPs are emigrating, and retiring GPs cannot be replaced, with resulting increased pressure on the rest of us. It's hard to see where the fairness or Public Interest lies in that.

We have one of the most expensive yet inefficient health systems in the world. Years of successive cuts in Government funding for General Practice has created an inefficient unstructured health system, which is now collapsing.
Young, newly trained GPs are emigrating and older GPs are giving up and retiring early.
The number of doctors who can no longer take on any more patients is a growing crisis, The medical card system can no longer cope, having been starved of resources for a decade and there are not enough GPs to serve the public and many are having to retire early due to burnout.
Evidence from around the world confirms that community-based health systems, like the family doctor system, are the most efficient, safe and effective solution, but despite this the politicians are not listening and ludicrously this government seems determined to suffocate and destroy General Practice.
Just 3.5% of the total health budget goes to General Practice. And we believe that it is time that our public representatives are held to account for this grave failure.

We are tired of saying sorry......

"Sorry we are not taking on new patients, we don't have enough time for the needs of our existing patients"
"Sorry we can't give you a same day appointment. If your problem is urgent, please go to the Emergency Department".
"Sorry your village no longer has a GP, the job is so unattractive that no suitable applicants wanted the position when your usual GP retired. Ireland trains excellent GPs who are attracted to better jobs abroad".
"Sorry our appt time is up. You have more problems? The next lady is already complaining about waiting, you'll have to come back another day."

"Sorry our nurse is only here part-time due to funding cuts, can you take a day off work to get your test done?"

"Sorry your own GP doesn't have time to see you today but neither do I".

"Sorry I can only give you a few minutes per consultation -there are so many people with urgent problems who all want to be seen today"

"Sorry you have been waiting an hour to be seen, I have had 2 mental health crises so far today which can't possibly be managed in 15 minutes, and 2 other emergency visits ahead of you"

"Sorry I can't do an overall free check-up for you in addition to your current problems, the medical card contract doesn't cover screening services. Yes I'm aware we should be resourced to do more preventive care, perhaps a new GP contract will resource this. Please ask your TDs when this will be prioritised".

"Sorry you are still waiting for me to write that report, I haven't had time to do it at work and fell asleep trying to write it last night"

"Sorry I can't do housecalls any longer as I'm just too busy with the surgery workload, and the HSE funding for home visits has been withdrawn from GPs. Perhaps a HSE nurse can go instead – you should phone your TD to see what services are funded locally."

We should not have to apologise on behalf of the HSE...

"Sorry you have to pay to see the GP. Hospital clinic appts are free, but as a result have a 2-year wait. Promising something for free doesn't guarantee good service, it needs proper resourcing."

"Sorry you were taken off the waiting list after I referred you to the hospital clinic – my validation list checking department hasn't been invented yet so I don't have time to double check all letters that come in to say you didn't respond"
"Sorry, you have to wait two years for an outpatient appointment."

"Sorry there is no reliable in-between safe access option between the Emergency Department and two year wait for outpatients, which would you prefer? Are you an emergency yet?"

"Sorry I have to refer you to the Emergency Department as it's no longer safe to wait two years, please ensure you bring snacks and a book as it may take 10 hours."

"Sorry I'll have to just send you to the Emergency Department as I have been holding 15minutes on the phone for the hospital team to take my call and fast-track you but I can't wait any longer as there are so many in the waiting room"

"Sorry you are feeling suicidal and don't want to go to the Emergency Department because of previous experience there. We used to have a suicidal crisis nurse but this service is not currently available. I wish I could find some other solution for you."

"Sorry that I can't refer you to a HSE psychologist for the mental health therapy you need. This service has not been funded."

"Sorry that I can't refer you for free counselling services, this is only available for medical card patients. Your GP visit card gives you zero entitlement to the other services you need. Those above the eligibility cut-off get nothing either......but Doctor Visit Cards sounded great when the Minister for Health told you that you were eligible for one, didn't they?."

"Sorry the free medical card counselling service has a 9-month waiting list. Can your mental health problems just go away while you wait?"

"Sorry, you have to wait four years for your hip replacement".

"Sorry, you have to wait five years for your cataract surgery."

"Sorry, you are unable to access physiotherapy, psychology, podiatry and all the other ancillary services that make a health system work efficiently and safely".

"Sorry, your relative died on a waiting list before their appointment came around."

Why should we have to apologise for our 2- tier system? We didn't create it.

"Sorry the waiting time for an outpatient appointment is two years, can you afford €200 to pay for a private one or are you happy to wait?"

"Sorry I can only get you access to medications for your mental health problems. Can you afford to pay privately for the talk therapy services you need?"

"Sorry the waiting time for an ultrasound is 9-12 months, I know you are having a lot of pain, you could have this done next week privately if you can afford €200"

"Sorry I can't refer you for a MRI in the public system, I have to refer you to Orthopaedics (two year wait) who may sign the form to put you on a further two-year waiting list for MRI. Can you afford €250 to get one privately in two weeks?"

"Sorry I know your health insurance will only pay for an MRI but you need an ultrasound based on your symptoms. Do you have €200? You may get a third of it back in a few months"

"Sorry I can't access free physiotherapy for you in the timeframe you need it, ie this week. There is a 6-9 month waiting list. Can you afford a few private sessions?"

"Sorry I can't order a Dexa scan for you in the public system despite your strong likelihood of osteoporosis. Can you afford €100 to get this privately?"

Sorry we can't manage the fallout from the hospital system any longer....

"Sorry you have to pay extra for bloods, screening tests and other services here. The current GP contract is 48 years old and not fit for purpose."
"Sorry you feel you weren't managed well after a 10-hour wait to be seen yesterday in hospital, what can I do for you today?"
"Sorry they didn't have time to explain your new diagnosis clearly enough, I would help, but I haven't received a letter from them yet"
"Sorry you can't afford to be out of work as no paid sick leave, but your back pain will get worse if you go back in. You may get small social welfare payments if you can manage the first 6 days unpaid. You can only afford 3 days unpaid – so sorry I don't know what to do".
"Sorry the social welfare illness benefit payments are in chaos so you may or may not receive any sick pay in the first 2-3 weeks of being on unpaid sick leave. You can't afford that? I don't know what to do for you. Maybe more painkillers would tide you over".
"Sorry I can't refer you to the HSE free dietitian service to help manage your obesity and diabetes risk. They only see patients with diabetes. Can you wait until you actually develop diabetes? I wouldn't recommend this..."
"Sorry I can't do a vitamin D test for you as our local lab won't do this for GP patients. Yes I am aware most Irish people are deficient, we have been told we should just guess how deficient you may be and guess the correct replacement treatment for you. Try another county where it may be available".

Sick of having to apologise for not being allowed to do what we are trained to do....

"Sorry I don't have time to remove that skin lesion myself, the funding from the HSE doesn't come close to covering the cost of disposable equipment and doctor time required. I will refer you to the hospital who should call you within a year. Yes I know they are too busy for minor things but funding cuts to General Practice mean we cannot prioritise loss-making procedures".
"Sorry I have to keep leaving the room to borrow equipment from other rooms, we can't afford to have sufficient equipment in every room since the funding cuts."
"Sorry the clinic is not as clean as it should be, we can't afford to hire a cleaner every day since the FEMPI funding cuts. The HSE contributes nothing to these costs."
Sick of apologising to my staff.....
"Sorry that you can't have paid maternity leave, sick leave and pensions as your colleagues in the HSE have. The government don't resource this in General Practice the way they do for themselves and HSE."
"Sorry you have to search the building for the doppler, we should have one in every room to speed things up but can't afford to."

Sick of apologising to my friends and family......

"Sorry I won't be home before my son gets to bed. I'm so behind on referrals and paperwork and haven't even had time to write up some of the notes from today yet."
"Sorry I can't go to that meeting, I'm on call that night. Again."
"Sorry I can't meet you for dinner, I have another medical education meeting that night."
"Sorry I don't visit as much as I should. I just don't have enough free time and am usually catching up on paperwork at the weekend. Maybe next year will be better."
"Sorry we can only take 1-2 weeks holiday per year, despite advising others in high stress jobs to take at least 1 week off per 3 months. GPs don't get paid annual leave. The cost and lack of availability of locums is prohibitive, along with guilt over the demand for having enough appts available to patients."
"Sorry that I have had almost no exercise in the last few months. I'm good at advising others though. Maybe next year will be better"

The aim of this protest is to highlight that GPs are 'SICK OF SAYING SORRY' and that a complete reversal of FEMPI without preconditions, followed by a new appropriate GP contract, is now the only option that will be accepted by General Practice.
The system urgently needs to be stabilised BEFORE anyone starts to talk about giving us new work. There simply aren't enough of us to do the current workload, in the community or hospital.
We are all united in saying this....
Minister Harris, please listen and sort it out before we fall deeper into crisis.

Dr Sinead Murphy


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