Out of hours services in Fingal “appaling” says Boland

Fine Gael TD Grace Boland has said that out-of-hours doctor services in Balbriggan, Skerries, Rush, and Lusk are “appalling.”

Boland said that despite the very tip of the Northside having 68,000 people living there, per the 2022 census, medical services for the area are not keeping up with the growing population.

Boland (along with local Labour TD Robert O’Donoghue) has raised the issue in the Dáil in recent weeks, but Boland said “I am getting no answers back.”

Per Boland, the D-Doc service was established in 2006, a time when the population of coastal Fingal was half of what it is now.

The 2002 census placed Balbriggan’s population at just over 10,000, while the 2022 census placed it just below 25,000.

Boland said that medical infrastructure is not scaling up in accordance with the area’s population. 

“The population of Balbriggan, Skerries, Rush and Lusk, and the rural villages of Garrettstown, Naul, Ballyboughal, Rolestown, Oldtown and so on, have all grown hugely since 2006, yet our healthcare services have not expanded in line with population growth.”

Boland noted that overall, the population of the North Dublin coastal towns stands at around 68,000.

“I have tabled many parliamentary questions for the Department asking what the criteria are to get the expanded D-Doc services, and I am getting no answers back about the criteria,” she told the Dáil.

“There has been major housing growth, and we are continuing to see major housing growth. The reality is that Fingal is the growth engine for housing in Dublin if not the country, yet we have not had the increase in health services, education, public transport, roads or other services that need to go with the delivery of houses.”

Boland said it was “concerning” that the HSE service planning is relying on historical data trends, and that they are working off the belief that a service established in 2006 can still operate in 2026 with no changes to the operating method.

In response to Boland’s parliamentary question, she was informed that she could avail of D-Doc services in Ballymun, Coolock, or Hartstown in Dublin 15.

She said that the closest D-Doc service for people in her constituency is the North Strand Health Centre in Dublin 1, or in Swords.

“The reality is that the Swords D-Doc only stays open Monday to Friday until 11 o’clock and, at the weekends, only from 9.30 a.m. to 10.30 p.m. We simply do not have access to 24-hour healthcare.”

Boland said, “you absolutely have to have a car to access any of these health services. There is no direct publ, ic transport service to them except for Swords which, as I have just said, closes at either 11 p.m. or 10.30 p.m. It is not good enough and I would really like to understand what the Department of Health is going to do to meet demands in the area.”

Taking the question on behalf of Fine Gael colleague Jennifer Caroll MacNeill, Southside TD Neale Richmond said “I sometimes question, when replies are being drawn up, whether people look at maps or live in the areas.”

“I know where Clonsilla is. I also know where North Strand is. It is a long way from Balbriggan. It should not take a Southsider to tell someone that,” he remarked.

The Dublin Rathdown TD said, “I could also talk about the responsibility of every GP to make sure they are providing a genuine option for out-of-hours care for their patients as per their contractual requirements and, increasingly, how those out-of-hours services have been developed and expanded over time, and how they are working extremely well in so many parts of the country.”

He said that the situation “requires attention,” and said that the number of GPs in the system should be looked at. 

“Genuine and forceful efforts are being made on her behalf to make sure we have more general practitioners, both through the additional annual investment and through the conclusion of the GP GMS agreement,” he explained.

“Something that we talk about, which is particular to this issue and which is parallel, not the solution, but complementary to it, is to have a greater D-Doc facility that goes into the north county; that is obvious to the Deputy and me, and indeed obvious to the Minister.”

He noted that at one stage, Stepaside had the distinction of being the fastest-growing area in the country, and now Blabriggan has that honour; in the case of Stepaside, extra resources were made available to the area at that time.

“One of the key areas to cover the wider north county area is the development of the Swords surgical hub, which will be operational from this summer. It will draw on and replicate the success of Tallaght and Mount Carmel elective surgical hubs, one is in my own constituency,” he explained.

He said that Mount Caramel, in Richmond’s own constituency of Dublin Rathdown, has reduced waiting times for patients.

He explained that once the swords surgical hub is up and running, it would be able to carry out 8,000 day care procedures per year, along with 5,700 minor operation procedures.

Boland said that the surgical hub in Swords is “welcome,” but it does not tackle the fundamental issue of her area not having healthcare facilities.

“People get sick every time of day and night and need access to a GP; the infrastructure exists in Balbriggan, we have a primary care centre. The population demand is clear. The growth projections are clear.”

“What I am concerned about is that the response to the parliamentary question I received told me there were no plans to expand the GP services in the area. I hope that I am hearing from the Minister of State that the HSE and Minister are open to expanding services.”

Boland recounted her own experiences with the poor healthcare facilities in her area, saying, “I have been that parent who has had to drive two premature twins to Swords to try to find GP healthcare. The reality is that I did not have access to a car at the time and had to ask a neighbour.

“We need to have clear criteria from the HSE and the Department about when we can get a D-Doc service and a timeline for expanding the services, and access to 24-hour GP care,” she said.

Richmond iterated that the government is “committed to the continued development of our general practice service to ensure patients across the whole country have timely access to GP services.”

“Work is ongoing to increase the GP workforce and therefore improve access to both daytime and out-of-hours GP services. Significant investment has taken place in general practice both in the 2019 and 2023 GP agreements, but we need to do a lot more,” he conceded.