The crisis facing GP services in Fermanagh is such that this retiring GP cannot leave his post because there are no GPs to replace him.

Three out of four practices in County Fermanagh are now at risk of closure due to workforce and workload issues.

Medical experts have predicted that GP services in Fermanagh will “collapse” by next year if rescue measures are not put in place.

Enniskillen services will feel the pressure later this year, as GPs in the county town step down.

Dr. Roy Leary, who retired as GP Principal at his Lisnaskea Health Centre practice on Tuesday, cannot leave his post because there are no GPs to replace him.

Read: Minister working on ‘high quality’ GP service after impending retirements

After 31 years of caring for over 2,000 patients, Dr. Leary has decided to remain until practices across the Erne East area have been amalgamated.

The experienced GP believes that Enniskillen – where 40 per cent of the local population are registered with a GP – will be the next area of the county to feel the pressure as GPs there are set to retire during 2017.

Impartial Reporter:

Erne Health Centre, Enniskillen treats 40% of Fermanagh's population. 

The Belfast-born GP, who has made Fermanagh his home, was not surprised last year when the Chairman of Northern Ireland’s General Practitioners Committee (NIGPC) Tom Black said “three out of four practices in County Fermanagh are now at risk of closure due to workforce and workload issues.” Dr. Black estimates that GP services in Fermanagh will “collapse” by April 2018 if rescue measures are not put in place.

“I grew up in the NHS,” stated Dr. Leary. “I’ve done my best for the NHS and I’d hate to watch the system undergo change. A lot of us (GP Principals in Fermanagh) have invested heavily in our practices and we feel worried about our patients and staff.”

His message to Northern Ireland politicians is: “They need to take action to redress the situation.” 

Read: GP’s ‘cry for help’ and ‘act of desperation’ to save services

There are currently 37 GPs working in 17 practices across 12 towns and villages in Fermanagh, with 67,090 patients, according to Health and Social Care Board (HSCB) figures.

Last year, Ederney, Castlederg and Newtownstewart GP practices amalgamated to form Western Rural Healthcare and Dr. Brendan O’Hare is now covering the Ederney surgery. Dr. Collins resigned from Rosslea and Lisnaskea Maple Group Practice is providing medical cover until a permanent solution is in place. Dr. Smyth retired from his Maguiresbridge surgery and that practice is now closed. Brookeborough surgery has taken over and are currently employing locums to treat the additional patients.

Now that Dr. Leary has retired and Dr. Devlin in Newtownbutler is approaching retirement, negotiations are underway with the HSCB about an amalgamation of services in Lisnaskea, Newtownbutler and Rosslea.

Lisnaskea was promised a new Health Care Hub nine years ago but it never materialised. The 1970s building has leaking ceilings and an inadequate heating system therefore Dr. Leary wants any new amalgamation structure to utilise the surgeries in Newtownbutler and Rosslea, which are in a good condition.

He told The Impartial Reporter: “All local GPs have been working hard since May 2016, looking at ways to try to stop primary care going from this part of Fermanagh. Enniskillen is going to hit pressures soon but this area is currently facing pressures.”

Read: Read: Minister working on ‘high quality’ GP service after impending retirements

During three decades as a GP in Lisnaskea, Dr. Leary has noticed that the ageing population means growing numbers of patients with complex conditions that are difficult to deal with in the normal 10 minute consultation time. He welcomed this week’s call by the Royal College of GPs for longer appointment times but noted: “That becomes difficult if you don’t have enough GPs.”

Dr. Leary was among the 97 per cent of GPs across Northern Ireland who agreed in December that they would be willing to sign an undated resignation from the health service should a rescue package not be announced by the health department. He described as “unprecedented” and “pretty dramatic” the NIGPC’s decision to go ahead and gather those undated resignations because the department has not yet announced a rescue package for general practice.

Read: GP’s ‘cry for help’ and ‘act of desperation’ to save services

He remembers “many politicians” visiting Lisnaskea Health Centre, which he describes as being in “the worst” condition in the county. “When they announced the new health centre in 2008 I joked that it would be up when I was retiring but now I’m retiring and there’s still no money for it. The Ministers keep changing and you don’t know who to speak to. I don’t know that there’s any answers today or tomorrow but the politicians need action to redress the situation.”

He stated that the state of the Lisnaskea building “adds to the pressures we face generally.”

GP services in Fermanagh

  • Belleek: Rathmore Surgery - 3,994 patients and three GPs
  • Brookeborough: Brookeborough Surgery - 3,207 patients and two GPs.
  • Derrygonnelly: Dr. Khew - 1,908 patients.
  • Derrylin: Dr. Aisling and Dr. John Kirby - 2,146 patients.
  • Ederney: site of Western Rural Healthcare - 1,528 patients .
  • Enniskillen: Lakeside Medical Practice - 7,080 patients and three GPs; Dr. Cathcart and Partners - 7,174 patients and five GPs; Drs Armstrong, Toal and Maguire - 4,273 patients and three GPs; Devenish Practice - 4,002 patients and one GP; Drs Mallon and McConville - 2,939 patients and three GPs.
  • Florencecourt: Benaughlin Surgery - 3,312 patients and two GPs.
  • Irvinestown: Irvinestown Health Centre - 7,758 patients and four GPs.  
  • Lisnaskea: Dr. Leary - 2,222 patients and two GPs; Maple Group Practice - 8810 patients and five GPs.
  • Maguiresbridge: closed - 1,908 patients.
  • Newtownbutler: Dr. Devlin - 1,934 patients.
  • Rosslea: 1,478 patients and one GP.
  • Tempo: Tempo Medical Centre - 1,554 patients and one GP.