Skills mix: future health policy and workforce planning in primary care.

摘要

The Department of Health strategy document, Primary Care: A New Direction, proposed primary care as the "team-based approach to service provision which will help to build capacity in primary care and contribute to sustainable health and social development". This strategy envisioned the establishment of a network of primary care centres staffed with GPs, nurses, physiotherapists, and social workers amongst many other health professionals. The successful implementation of universal primary care in Ireland is dependent on a number of factors, not least capacity and workforce planning. Concerns regarding the age, gender and working patterns of general practitioners have been expressed. Younger GPs indicate a preference for shorter working hours and earlier retirement. Female GPs tend to work a shorter working week compared to male GPs (although this may be shifting amongst younger GPs). In addition the GP per population ratio (52/100,000) is lower than other European countries (France 164/100,000), appreciating that this does not allow for structurally different health systems and role definitions. It is projected that the growing number of older patients, retiring GPs and the increasing feminization and part time nature of general practice will lead to a gap between supply and demand if even the current low ratio of GPs per capita is to be maintained3. In addition the introduction of universal access has been projected will remove the artificially low attendance of some patients to primary care and increase attendance by 17%. Finally it is accepted that the enhanced nature of primary health care, incorporating chronic disease management will require far more GPs than are currently working in the system.