Concerns have been raised around the Department of Health's ability to recruit and retain GPs as 13 contracts have been handed back in six months.
In a presentation given to Belfast City Council's City Growth and Regeneration Committee and seen by Belfast Live, representatives of the Department's Strategic Planning and Performance Group (SPPG) told Councillors that 21% of the GP workforce on average are in the 55 year+ age group and therefore may be likely to retire within 5 years.
The committee were informed that there were 1,419 active GPs across Northern Ireland at March 31, 2022. This is a 0.6% increase in the number of GPs since 2021 and a 20.3% increase since 2014.
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However, the SPPG told councillors that not all GPs work full-time hours so changes in headcount may not reflect the change in full time equivalent GPs.
While Belfast has the highest number of GPs per 100,000 people, with 359 GPs working across 77 practices, SDLP councillor Brian Heading told Belfast Live that he wasn’t surprised but "angered" at the details concerning GP provision in the city.
"The information provided by Strategic Planning and Performance Group at a City Council Committee meeting should of major concern to families," he said.
"Every day we hear about difficulties surrounding appointments of vulnerable people who are attempting to explain symptoms over the phone or not being able to access their GP and going straight to the hospital casualty department.
"A combination of age, retirement, extra indemnity costs for practising medicine here in the North and more administrative bureaucracy is driving good doctors into early retirement and away from the NHS.
"In the coming years we will be facing a crisis in our GP service through the failure of the Health Department to fund more training places and resolve issues on how the service can be delivered to those who need.
"We owe a debt to those GPs who worked alongside other front line staff and served in hospitals during the pandemic. We need to retain and train more GPs and the Health Department need to be called to account.“
Dr Michael McKenna from the British Medical Association's Northern Ireland General Practitioners Committee told Belfast Live that we have a huge workforce crisis across Northern Ireland.
"While we have younger GPs coming into the workforce, we are losing too many older GPs through retirement and burnout," he said.
"We have seen 13 contract hand-backs in less than six months which has a destabilising effect on neighbouring practices from list dispersals.
“Pressure in general practice is such that becoming a GP partner with its associated responsibilities is no longer an attractive career option. It is therefore no surprise that a significant number of newly-qualified GPs are either opting to work as locums for increased flexibility and autonomy, or work less than full-time for portfolio careers with other specialties or because of family commitments.
"A part-time GP in Northern Ireland actually works 40 hours a week, which you simply would not class as part-time in any other profession."
Dr McKenna added that we need to urgently resolve our workforce crisis and ensure that general practice has a sustainable future.
"We need to address the indemnity issue, stabilise the workload and move away from the narrative that GPs are working ‘part time’ or are closed to patients when GPs across Northern Ireland are doing the very best they can to meet demand.
"There are many short term interventions the Department of Health could do now to halt this crisis even in the absence of a health minister and functioning Assembly: freeze QOF, address spiralling indemnity costs and simplify what is being asked of practices to ensure maximum access.
“Long-term, we need the assembly back and running to ring-fence a multi-year health budget, implement the full and fair roll-out of MDTs in all areas of Northern Ireland and to address unfair pension taxation rules.”
A Department of Health spokesperson said: "DoH Officials recently engaged with Belfast City Council, City Growth and Regeneration Committee in relation to the provision of General Medical Services in the Belfast area.
"The Department continues to invest in General Practice to help meet increasing demand. A £5.5m package for General Practice was announced in September to help strengthen GP services through the winter period as well as providing help to those practices that are most at risk.
"The package provided targeted help to parts of the service that are most under pressure by investing £1m in a new Attract, Recruit, Retain scheme to help attract GPs in traditionally hard-to-recruit areas. As part of this investment package, additional funding is provided to the GP Crisis Response and Improvement Team, which provides support to Practices that are experiencing difficulty.
"The Department also agreed new arrangements with GPs to reduce the administrative burden on Practices over the winter and allow them to prioritise care for their patients who most need it, with a particular focus on those in care homes.
"More broadly, action has also been taken to support General Practice through increasing the number of GP training places in Northern Ireland to an all-time high of 121 in 2022/23.
"Looking to the longer term, a review of the GP workforce has been progressing, and the Department will consider the review’s recommendations on the need for GP training places in the future.
"The Department has also recently streamlined the processes for GPs qualified in the Republic of Ireland, Australia, Canada, New Zealand and South Africa to take up roles in Northern Ireland.
"In addition, and in recognition of the important role Health and Social Care professionals can play alongside General Practice staff in delivering timely and effective patient care, the Department has supported the Multi-Disciplinary Teams model with an additional £1.5m investment this year."
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