Leitrim county councillor and TD raise concerns about NoWDOC downgrade

Sinn Féin county councillor, Brendan Barry and local TD, Deputy Martin Kenny, have both raised concerns about the future of the out-of-hours doctors' service, NoWDOC.
At last week's meeting of Leitrim County Council Cllr Barry received unanimous support for a motion calling on the HSE to “give a commitment on the NoWDOC service, that there will be no reduction in opening times or service in Carrick-on-Shannon or the other centres in Leitrim, Sligo or Donegal.
“A GP should be available to people in the county 24 hours a day, to see patients and reduce pressure on our hospitals,” said Cllr Barry.
He pointed out that people in North Leitrim and parts of South Donegal already have to travel to Sligo to avail of out of hours doctors' services.
“I'd be very fearful that the services in Carrick-on-Shannon could be reduced and that people in South Leitrim could face a situation where they have to travel to Sligo (for some of the out of hours periods),” he said.
“Now is the time to get a commitment that there will be no reduction in service,” he said adding that we should be looking for “the enhancement of the service” instead.
Cllr Barry asked for a copy of the motion to be sent to the HSE and the Service Manager of NoWDOC.
His concerns were also echoed by Deputy Martin Kenny who said he has written to the Minister for Health regarding “the further privatising and likely downgrading of the NoWDOC service if HSE plans go head.”

Deputy Kenny stated, “This latest move to further privatise the NowDoc service has not yet happened and must be stopped, this plan by the HSE cannot go ahead as our community needs a proper and enhanced out of hours GP service and I told the Minister for Health he needs to protect this service.
“The way in which our national health service has been neglected to the stage that we do not have the capacity to provide hospital care in a timely and effective manner, during ordinary times, never mind during high demand periods, is the recent outrage.”
He said there's now the prospect of the NowDOC service “being totally moved out of the control of the HSE into the private sector under the total control of CareDoc, and the likely removal of services at certain times and overall reduction in out of hours GP services.
“It has come to light in recent days that the HSE and CareDoc, who are a partner in the NoWDOC service, are in talks about changes which would see the service being totally ran by CareDoc who are a private company that organise GP services.
“The first impact of this would be the calls being diverted to a centre in Carlow, followed by the withdraw of services from Carrick-on-Shannon to Sligo after midnight and indeed the long-term future of the Carrick-on-Shannon service would be in real danger.
“All such changes would be about making it “more streamlined and efficient”, in other words, lower cost.”
Deputy Kenny acknowledged “the present service has its problems and many people have complained about the policy of not accepting anyone without prior appointment, this is because they are not an “emergency service”.
He said the out of hours GP service should be a continuance of the regular GP service and in that respect needs to be enhanced.
“This latest move to further privatise the NoWDOC service has not yet happened and must be stopped, as our community needs a proper and enhanced out of hours GP service around the clock and it needs to be provided by the state agency, the HSE, that has responsibility for health services.
“I have written to the Minister for Health and asked him to protect and develop the NoWDOC service and ensure it is kept as a state service for the people of this region.”

Local doctor responds
However Carrick-on-Shannon based Dr Jonathan Egan said that the current speculation about changes or reductions in the local NoWDOC service is “not something I have heard anybody mention.
“The aim is to have a service that is as good as the one in the neighbouring area of Sligo/North Leitrim - at the movement we feel that is not the case,” he said.
“There has been some contact between Caredoc and the HSE. Caredoc is a not-for-profit organisation run by GPs and they have been partnered with the HSE for several years in running NoWDOC, and from my perspective, as a GP, have been responsible for an improved service since they became involved.
“Caredoc have been in full charge of the out of hours service in our neighbouring area of Sligo/North Leitrim for some years and that service is very well run,” he pointed out.
Dr Egan told the Leitrim Observer that local GPs have been “critical of deficiencies we see in the current local service especially as regards the triage centre in Letterkenny.
“This service is very unsatisfactory, especially when compared with similar triage centres elsewhere in the country such as the one in Carlow which is already providing the triage services for Sligo/North Leitrim very successfully,” he said.
“We would like to see the service run in a more similar fashion to how our surgeries operate i.e. with more input from doctors rather than HSE-appointed managers.
“There are several local GPs including myself involved in a voluntary capacity with Caredoc so we have some insight into how it is run, but we have no such input to the current HSE run operation.”

HSE have commenced ‘exploratory discussions’
The HSE has acknowledged that “exploratory discussions” have commenced with stakeholders about the most “effective arrangements” needed to continue to deliver a safe service for our community and the need to “examine the potential redesign of the operating model for the GP Out of Hours service in Donegal and South Leitrim going forward.”
In a short statement the HSE noted “We remain fully committed to supporting our staff who are working in our NoWDOC service, and will ensure that we are engaging with staff directly and with their representative bodies throughout these discussions.
“The HSE will continue to communicate and engage with all relevant stakeholders to ensure they are fully appraised of and consulted on any future developments.”

The HSE said that the current operating model of GP out of hours service is managed and delivered by the HSE as part of a hybrid model with Caredoc providing GPs for the delivery of care.
“The HSE are continuing to work in partnership with NoWDOC and Caredoc to ensure that the public using the GP out of hours service, and the staff working in the service, are provided with the necessary supports to deliver the best care to our service users, while ensuring that patient safety and quality of service are at the forefront of service delivery. There has been no reduction in the GP out of hours services.”