December 2001 Important new findings on Irish Rural General Practice

Irish rural practitioners, in comparison to their urban colleagues, work longer hours, have more public patients, are more likely to work from purpose built premises which are publicly owned and participate more in a team approach to patient care delivery. The results of a national census on general practice in Ireland, with an emphasis on rural general practice, has just been published in the international journal Family Practice. The project was conducted, with the significant support of the Irish College of General Practitioners, by Dr. Saoirse Nic Gabhainn (Assistant Academic Director, Department of Health Promotion, NUI, Galway), Professor Andrew W Murphy, (Professor of General Practice at NUI, Galway) and Professor Cecily Kelleher (Professor of Health Promotion at NUI, Galway).

Completed questionnaires were returned from 2,093 General Practitioners which was an 86% response rate. Information on 1429 practice centres were provided; 34% of these were designated as city, 28% as town and 38% as rural. Dr. Saoirse Nic Gabhainn said : 'We were especially pleased with both the high quality and quantity of responses to this census. This could only have occurred because of the significant support which the Irish College of General Practitioners provided to the study'. The mean number of public or 'GMS' patients per general practitioner was 740 for city, 818 for town and 865 for rural locations. Professor Andrew W Murphy commented that : 'Public perceptions of poverty are dominated by urban images yet the health implications of poverty are universal and irrespective of location. Combining these figures with the distances which patients live from acute hospitals emphasises the workload implications of rural poverty for General Practitioners.

70% of rural practitioners have weekly contact with a public health nurse; this compares to 30% and 38% for city and town practitioners respectively. 54% of rural practitioners have weekly or monthly contact with a community psychiatric nurse; this compares to 30 and 39% for city and town colleagues respectively. The quality of these contacts is described much more positively by rural practitioners. Professor Andrew W Murphy said that : 'The recent primary care strategy emphasised the importance of teamwork. The results of this study suggest that what levels of teamwork currently exist in Ireland, do so largely in rural areas. Consideration of these rural primary care teams is worthwhile if the aspirations of the teamwork approach as outlined in the strategy are to be implemented.'

Smaller and more regional studies of rural practice from the United Kingdom, New Zealand, Australia and the United States have found broadly similar results. Dr. Saoirse Nic Gabhainn stated that : 'This means that, irrespective of the prevailing health care system, rural practice appears to have distinctive characteristics. Specific programmes to support the development and delivery of rural general practice are therefore appropriate.'

Mr. Fionán Ó Cuinneagáin, Chief Executive of the Irish College of General Practitioners, commented: 'The results of this important study emphasise the unique role which Irish rural general practitioners play in the delivery of healthcare in this country. For this role to continue, and to develop, it is important that substantial support be given to rural practitioners in reducing excessive workload and guaranteeing locum coverage and the provision of distance learning programmes. It also highlights the important contribution which academic general practice can make in the formulation of policy development.'

sor Andrew Murphy is available for interview on the findings of the national census

Information from: Máire Mhic Uidhir, Press Officer, NUI, Galway. Tel. 091 750418

Professor Andrew W Murphy, Department of General Practice, NUI, Galway Tel : (091) 750470