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Outrage as NoWDOC
services to be downgraded

Local residents and doctors are outraged by the HSE’s plan to downgrade the NoWDOC, out of hours GP service centre in Carrick-on-Shannon.

Local residents and doctors are outraged by the HSE’s plan to downgrade the NoWDOC, out of hours GP service centre in Carrick-on-Shannon.

The HSE plans to remove weekday secretaries and halve weekend cover in the Carrick centre from mid-November, which will “affect patient service” according to local Doctor Jonathan Egan.

Dr Egan said the HSE will cut all secretary cover from 6pm to 8am during the week and will provide only 10am - 8pm cover for the weekends (the service itself runs until midnight on weekends). The cutbacks will mean that patients who arrive at the NoWDOC Centre, when a doctor is out on call, will be faced with a “locked door” showing the Letterkenny Call Centre phone number. Calling this number should provide the patient with a time for an appointment with the doctor.

Dr Egan said although a phone call to NoWDOC goes directly to Letterkenny before calling to the centre, a large number of the cases they deal with present themselves directly to the Carrick centre.

The new situation will also mean that if a doctor is dealing with a patient in the centre and needs to leave for an emergency call out, “the patient will be forced to leave the building and sit in the car or return home to wait for the doctor to come back,” explained Dr Egan who spoke to the Leitrim Observer on behalf of Leitrim’s 19 doctors who service the centre.

The doctors say the removal and reduction of secretary hours will result in an “unprofessional” service. Doctors believe the “downgrade” will push people to ignore the NoWDOC System and to return to crowding hospital A&Es. Dr Egan believes that the new arrangement “goes against” all efforts to transfer people from hospital emergency services to primary care.

The Carrick-on-Shannon NowDoc Centre at Inver Gael covers the majority of South Leitrim and North Roscommon and includes 19 doctors working on a rota basis. The centre also employs five drivers who work a rota and four secretaries. The NoWDOC Centre opens from 6pm to 8am weekdays and from 9am to midnight on weekends.

Dr Egan also said that it is understood that very little savings can be found from the downgrade as the secretaries cannot be made redundant under the Croke Park deal so will be transferred to work for diabetes eye clinics. He said the affected secretaries have already starting their training for that new role.

Local doctors believe that savings can be made elsewhere without having to downgrade the service. They understand “tens of thousands” is being spent annually on the rent of the NoWDOC Centre and this could be renegotiated. They also think savings could be sought in medicines, and in car maintenance. As part of the new arrangements, doctors have also been informed to write all their notes in block capitals as secretaries will not be available to type up notes on patients to be sent to hospitals and for local doctor files, which the doctors say will take up essential time.

Dr Egan said all Leitrim GPs are “vehemently opposed” to the downgrade and changes which are expected to be put in place by mid=November.

Cathaoirleach of Leitrim County Council Enda Stenson has also come out against the news. He called the move “crazy” and “outrageous.”. He said the HSE can “no longer call NoWDOC an out of hours service anymore.” He said if the doctor is on a call there is practically “no service available” to those who visit the centre. He said the decision by the HSE which seems to bring about minimal savings makes “no sense”. He said the cuts put “more pressure on GPs and must be reversed.”

Fine Gael Deputy Frank Feighan has promised local doctors he will raise the issue with Health Minister James Reilly. The HSE failed to give a more definite date for the changes when asked by the Leitrim Observer.

A spokesperson for the service said “The HSE are implementing the recommendations of the National GP Out of Hours review, which was published in 2010, and in so doing, are looking at all operational activity, including staff who are employed by the HSE, to ensure that safe and efficient services can be maintained in the current challenging financial environment. This review to date, has resulted in the HSE submitting proposals to the Trade Unions regarding the redeployment of receptionist staff in the NoWDOC centre in Carrick-on-Shannon and three other sites, under the provisions of The Public Service Agreement 2010 - 2014. Plans have been developed to ensure that there is a seamless transition to the new staffing model, and consultation is ongoing, with the General Practitioner members of NoWDOC, in Carrick-on-Shannon. The proposed changes to the staffing model, does not constitute a reduction in services in the Carrick-on-Shannon centre, as these proposed changes reflect the staffing models, that operate elsewhere, and will provide for the continuity of safe patient care at each of the centres.”

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