“The HSE have taken the approach that D Doc needs to be assessed from a cost only perspective and seems to have gone away from any social or patient focused values the service provides“
“This is not the time to unpick and unravel one of the best primary care services in the country.”
At the Northdoc AGM earlier in the year we explained that Northdoc’s income continued to decline from the effects of FEMPI cuts and unrealistic funding from the HSE. We also said that we were working closely with the HSE in an effort to resolve the funding issue. Since we started the Northdoc/ HSE partnership we have had many challenges. We worked together and we worked through them. The single biggest challenge over the last few years has been the funding.
The HSE has until now shared the same value we have of the service, and has, until now, underpinned that value by filling the funding gap where it was needed. The HSE has always recognised the Northdoc input, not just in terms of supplying an important component of the service (GPs) but they have always valued our overall commitment to D Doc, ensuring that the service provides a GP service to North Dublin patients that is second to none in terms of medical standards and patient safety. In Northdoc our values have not changed and neither has our commitment to providing an excellent GP out of hour’s service to the people of North Dublin.
The HSE appears to have changed its partnership approach to the funding problems. Loss of institutional memory of the quality of the service compared to what existed before D-Doc has resulted in a foot dragging approach to the funding problems that have been well flagged for years. In recent talks they have explained that any cost savings their end might take ‘years’ to introduce and instead have insisted on focusing, yet again, on what further cost savings Northdoc can provide. The Board of Northdoc are clear that there is no further room for this in the company when we have lost 140,000 euros for the first time last year and are on track to lose 180,000 in 2015.
Set up as not for profit company, Northdoc has, since the service commenced, ensured that all fees (including those from private patients) go back into the company to underpin the service. Last year, one million two hundred thousand euro of private funds were used together with STC payments and a small HSE grant to provide the service.
Despite Northdoc cutting pay to GPs and service efficiencies being introduced ,Northdoc continued to provide excellent service (average waiting times during hospital crises at Christmas was 45 minutes in D doc). 90% of North Dublin GPs were on duty at critical times. Northdoc has the endorsement of MPS UK and a 95% satisfaction ratings from patients (April 2015). Despite this level of service the HSE continue to focus almost exclusively on the money they pay to Northdoc.
D Doc average waiting times of 45 min during peak demand compares favorably with A & E
At our latest meeting with the HSE they said they were looking at all of the service. They said that they would be looking at “the need” for maintaining five centres across North Dublin and they queried whether it was necessary to continue the current excellent waiting times for patients.
The HSE have taken the approach that D Doc needs to be assessed from a cost only perspective and seems to have gone away from any social or patient focused values the service provides. In recent talks they have explained that any cost savings their end might take ‘years’ to introduce and instead have insisted on focusing on what cost savings Northdoc can provide instead.
The HSE maintain they have no money for further funding and are saying we should look to a diminished service as the answer. We need to address this and we need to be united and firm in our response. The Northdoc/ D Doc model of care has evolved over the last eight years and all that is good about it is as a result of the hard work put in by GPs and their colleagues in D Doc at the front line of the service. This is not the time to unpick and unravel one of the best primary care services in the country.
If the HSE continue to undervalue and under-fund the service then it simply cannot continue and Northdoc will need to operate an alternative in line with current funding. This will mean the end of the D doc model as it has developed.
The board of Northdoc will in the coming weeks await the response of our final submission to the HSE management. Unless there is a commitment from them to adequately fund the service we will hold a meeting of all members to discuss our options. This meeting is currently scheduled for May 25th.
For more details and background please click here Northdoc GP Update from northdoc May 08th 2015
This is a private communication from Northdoc Medical Services board to members of the company. Do not distribute in whole or in part or any attachments.