The pressures being faced by the GP service in Northern Ireland (NI) is across the whole system – however, Dr. Tom Black, who chairs the British Medical Association (BMA) in Northern Ireland, believes that “Fermanagh is at the sharp end” in terms of the crisis in the workforce.

Speaking to The Impartial Reporter about the ongoing issues faced by GPs in NI, Dr. Black said: “We have been warning about that for a long time, and 10 years ago we were saying that Fermanagh would be most at risk, in terms of the GP work crisis, for geographic reasons – and it turned out to be the case.”

Breaking down some of the data, including a phenomenon where 80 per cent of medical school graduates stay within 20 miles of their graduating medical school, Dr Black said: “We know that 10 years ago, they weren’t training enough; they were training 65 GPs for Northern Ireland, and most of them went to Queen’s [University Belfast], and most of them prefer to stay within 20 miles of Belfast.”

Explaining further, Dr. Black said: “It’s a well-known UK-wide phenomenon in medical school graduates – 80 per cent of them stay within 20 miles of their graduating medical school.

“That was something we were aware of, and knew it from other medical schools.

“That’s why they had to develop medical schools in Aberdeen, Swansea and rural areas in England.

“That is why we eventually got the second medical school in Derry [at Ulster University, Magee].”

The BMA have highlighted the issue of GP supply in the West of Northern Ireland for some time, Dr. Black said.

“We warned the Department [of Health] that if you want to have enough GPs out in the West – and not just GPs, but hospital doctors as well for the SWAH and Altnagelvin – you need to be producing a higher number [of doctors].

“The number now they are producing is over 120 GPs, and they are even talking of 150, so ten years ago 65 was enough and now 120 isn’t enough. I think it shows we were right.”

Detailing the pressures being felt by general practice right across Northern Ireland, Dr. Black said: “If you’re looking at the pressures in general practice, the greatest pressure general practice has is not the relationship with secondary care [hospitals such as the SWAH] but the workforce crisis within primary care.”

He continued: “The biggest problem in Fermanagh is maintaining the sustainability of GP practices, because 90-95 per cent of problems are dealt with in general practice. For every 20 patients a GP sees, they only refer one on to hospital.”

He emphasised: “If you talk to GPs down there, and you ask them what’s the one thing you want, they will say, ‘More GPs’.”

Concluding, he said: “This winter pressure is going to continue through the next three months. Hopefully it will start easing up in April – then the next problem after that is what do we do with the more than 600,000 people who are on waiting lists for inpatients, outpatients and diagnostics, and how do you transform the service?

“The bottom line in all of this is that 10 years ago, the Westminster Government decided to start cutting back on health care spending.

“This is what happens when you spend a decade underinvesting in training, in staff numbers; doctors, nurses and other health care workers and, in particular, hospital beds.”