Primary care teams to reduce hospital lists

Up to 100 new primary care teams - comprising GPs, nurses, physiotherapists and other healthcare professionals - are to be established by the Health Service Executive (HSE) in the coming year in an effort to improve services for patients in the community and avoid referrals to hospitals.

Each of the 32 local health offices of the HSE around the country have been asked to establish three such teams in the months ahead. The chief executive of the HSE, Prof Brendan Drumm, said yesterday that the new teams would deal with around 10,000 patients and would provide services in the community which up to now were accessible only in hospitals.

He said the new teams would provide services over an extended working day, up to 10pm or midnight.

Separately, new community intervention teams involving GPs, public health nurses, care attendants and home helps are to be established to provide services which would allow elderly patients with short-term illnesses to remain in the community rather than having to go to hospital.

The HSE is also to provide funding to give GPs improved access to diagnostic services such as X-rays or ultrasound scans rather than having to refer patients to hospitals.

This could involve the provision of new diagnostic facilities in district hospitals. The HSE is also considering making provision for consultant radiologists to have an attachment to the community rather than specific hospitals. Such radiologists would interpret, via telemetry, scans taken in the new district units.

The HSE is also considering plans to allow GPs to seek diagnostic services from the private sector.

Prof Drumm, in an interview with RTÉ yesterday, maintained that patients were currently having to go to hospitals for services which in many countries were available in GPs' surgeries.

He again questioned the need for more acute hospital beds and stressed that the priority should be developing services in the community.

Prof Drumm said that he constantly faced calls for more investment. However, he said that he did not believe it to be justified "to ask continually for more money for a system that is not providing very well what has already been invested in it".

He said people called for more investment but without reform to make the system more effective," we would be back where we are in two years' time".

Prof Drumm maintained that lack of access to services in the community was adding to the pressures on hospitals and, in particular, on accident and emergency services. He said the system was failing in that patients were arriving in A&E in far bigger numbers than they needed to because they should have been seen elsewhere.

The HSE would also have to tackle "bottlenecks" in hospitals.

"We have up to 100 people when you take doctors, nurses, clerical people working in our A&E units seeing up to 100 patients per day going. That is one patient per person employed. That is a bottleneck we cannot continue with.

"That is not because the people in there are not working, it is because the system is so convoluted and we have to challenge that," he said.