An out-of-hours GP service could soon be available to more than half a million people in the midlands and north-east if negotiations succeed between doctors and health boards.
The North East Doctor-On- Call scheme (NEDOC) already caters for 310,000 people. When it soon expands to cover areas in north-east Dublin, it will have a catchment area of over 335,000 people.
But negotiations are also under way to provide an out-of-hours service with the Midland Health Board. NEDOC is willing to provide call centre support for the service and GPs in the midlands are discussing the plan with their health board.
If it goes ahead, an out-of-hours GP service could be available in Laois by September and would then be gradually extended to cover the rest of the midlands.
The project is partly being driven by rural GPs who work long and difficult rotas because of their isolated practices. The increase in the number of female GPs has also increased the demand for more family-friendly hours.
In the NEHB area, the service operates from 6 p.m to 8 a.m and for 24 hours a day during weekends and bank holidays.
After office hours, patients can ring a call centre to talk to a doctor on duty.
Of the 100,000 calls received by NEDOC since it started almost two years ago, 40,000 were dealt with over the telephone. Patients still had the option to be seen by a doctor if they so wished.
NEDOC runs four main treatment centres in Navan, Cavan, Drogheda and Castleblayney and 15 peripheral centres in Louth, Meath, Cavan and Monaghan.
GPs on a house visit are supported by a team which includes a driver, nurses and a radio control centre.
Mr Tadhg O'Brien, NEHB director of primary care, said the out-of-hours service was already the biggest such co-op in this State and was continuously developing.
He said the service was proving to be particularly valuable to elderly people and parents of babies. Many of these clients were reluctant to disturb a GP in the middle of the night, but once they knew there was a doctor on duty, they felt much happier making the call.
Although it was expected that some people would be reluctant to deal with someone other than their family GP, Mr O'Brien said this was not the case.
"If you go into casualty, you will probably get a junior doctor who has never seen you before. With this service, you are dealing with trained specialists in general practice," Mr O'Brien said.
The new arrangement has also been welcomed by doctors in the north-east. Some 80 per cent of GPs in the region are participating in NEDOC.
Mr O'Brien said the expansion of the service would help attract GPs to rural areas. Previously, the constant night work had dissuaded many GPs from taking up rural practice. "This is a massive reduction in out-of-hours work, and is so much better for home life."
The North Eastern Health Board (NEHB) is also working with its Northern Ireland counterparts on a cross-border, out-of-hours service.
This would mean that someone in Keady, Co Armagh, could benefit from medical attention in Castleblayney, seven miles away, rather than travelling to Newry, which is 27 miles away.