Sunday Independent 12 April 2020 6 Coronavirus crisis in the community Curious tale of Care homes in postcode one county’s lottery over Covid-19 virus fight

Wayne O’Connor

IT is three weeks since the first resident at Newbrook caseload Nursing Home in Mullingar contracted coronavirus. Since then, five more people have been infected, including staff and residents. Some elderly residents have been hospi- talised. “Our biggest issue was trying to put resources into fighting this,” Newbrook RESOURCES: Phil D’Arcy, CEO chief executive Phil D’Arcy of Newbrook Nursing Home said. “We shut our doors at the start of March, we flat- plained of receiving “shock- tened our own curve and we ingly little PPE” in a delivery got in the PPE orders and saw last week, and raised the issue it delivered before pressure with the HSE on Friday night. came on. That has helped us “Our staff have no issue cope but I know others have looking after residents with not been so lucky.” Covid-19 if they have appro- The home, in Mullingar, priate PPE, but unfortunately Co Westmeath, went into we haven’t received sufficient lockdown before the Gov- PPE,” it told the HSE in an ernment banned visitors to email that was marked ‘ur- nursing homes and hospitals. gent’. Then Ireland had just 34 Its delivery included 200 cases so Chief Medical Officer disposable aprons with short SOCIAL DISTANCING AT CHELTENHAM 2020: ‘Cheltenham will play a role in the Covid-19 cases in many counties, especially around the midlands,’ says one health professional. Photo: Gerry Mooney Tony Holohan labelled the sleeves. These are not deemed move premature. He was con- appropriate for dealing with cerned about social impacts residents with Covid-19 Testing, nursing home clusters, Mullingar, in the east of the sizeable hunt club commu- had a cluster of six cases. The due to the length of time re- symptoms. county and near the M4. nity, and, according to Horse six include both residents and strictions would be in place. Increasingly, nursing Cheltenham and a few local pubs are Local minister Kevin ‘Box- COUNTING Racing Ireland’s directory, staff. They have not amounted “As a sector, it was hard to homes are finding themselves er’ Moran said commuting THE COST seven trainers are based in to fatalities. In some cases, hear Tony Holohan question in more precarious circum- key to Westmeath’s coronavirus story, should be dismissed as a rea- the county. There is a keen residents have already made nursing homes at the start,” stances. There are almost writes Wayne O’Connor son. “People are starting to ask SIX BUSINESS interest in the sport here. The a full recovery and returned Mr D’Arcy said. “What we 120 Covid-19 clusters in the questions about the clusters in OWNERS TELL Sunday Independent spoke to to the nursing home after re- found was families ques- country’s 600 nursing homes. Westmeath,” he said. THEIR STORIES five trainers last week. None ceiving treatment in hospital. tioned our decision, but with A memo sent to residential OO often the peo- contracted the deadly virus “They want to know is it PAGE 12 of them visited Cheltenham. Health professionals in the the benefit of hindsight it was care facilities by the HSE ple of Westmeath at Milan Bergamo Airport on in Athlone, Mullingar, Kin- Four of them knew people who area attribute Westmeath’s the correct decision. advises them not to transfer are victims of cir- his way home, but even this negad. Some people think it had made the trip across the high coronavirus figures to “It has been a struggle. residents with Covid-19 to cumstance. Most seemed unlikely. is because people have been Irish Sea for the festival. testing. Without the staff we would hospital unless it “will confer Twinters, they battle “Security in the airport commuting up and down to “I know five or six people “When you look at any- not have been able to manage additional benefit”. They have against rising water, because was a bit different to what Dublin because Liffey Valley who travelled over and came where there is a high number the situation. I have heard been warned a resident’s land on the banks of the Shan- you would usually expect,” is just 45 minutes away on back with it,” one trainer said. of cases, you need to look at horror stories from other condition can deteriorate non is vulnerable to flooding. a source with knowledge of the motorway, but it’s not. It “Not all of them had it how many tests are being nursing homes where 40pc or rapidly if they have the virus Last winter was no different, the trip told the Sunday In- has got in to the communities [Covid-19] but I know some carried out,” a health source 50pc of staff are not showing so it is important to identify but this was nothing compared dependent. early. The commuting stopped of them did, and people some in the county said up for work.” with the deluge of Covid-19 “People were keeping their when people were told to work of them would be in contact “High levels of testing will Mr D’Arcy also paid trib- cases the county has had to distance, passengers had their from home.” with had it.” uncover more cases and it ute to the local HSE teams. ‘Families put up with in recent weeks. temperature taken, and he He was reluctant to expand There is anecdotal evidence appears we are testing more Last Friday, geriatricians and It seems Westmeath has was never in a confined space on why the area was so badly this had a role in community than other counties. HSE nurses were training questioned our fallen victim to circumstance for a minute with anyone.” hit, instead insisting people transmission around Mulling- “To really measure this nursing home staff, show- decision’ again, resulting in clusters, It was widely believed must focus on preventing ar, and this has been backed issue, you need to look at ing them how to conduct pubs and Cheltenham play- the boy was Westmeath’s further spread of the virus. up by a health professional deaths, but the coronavirus Covid-19 swabs. This means ing key roles in Westmeath’s patient-zero, but then his However, mayor for the source in the county. deaths in Westmeath are in residents will now have to end-of-life care preferences coronavirus story. test results came back nega- Mullingar municipal district “Cheltenham will play a single figures. wait hours rather than weeks in advance. The memo also It was one of the first coun- tive. It remains unclear how and Independent councillor role in the Covid-19 cases “They are very low. What for test results. warns against embalming a ties with a suspected case and Westmeath first contracted Michael Dollard was happy to in many counties, especially has happened here is more Other homes in the sector resident who dies of Covid-19, until a surge in Cavan last coronavirus. give his view on why eastern around the midlands,” they people are being tested and have not been so fortunate. In but washing the face, hands week, Westmeath was the This weekend it accounts parts of the county have been said. the contact tracing is more a letter addressed to Health and tidying hair is allowed. worst-affected county outside for 152 cases, significant given badly hit. Many locals claim to know effective. That is why it is Minister Simon Harris last A face mask must be then Dublin. Yet, does this rural the size and rural sprawl of its Mullingar is home to at a group who travelled to the possible to link cases. week, one nursing home com- placed on the body before it county appear to be worse off population. least one nursing home cluster festival and visited a pub in “Mullingar hospital is plained about the pressure is moved to a body bag. than more urban settings like According to the Central and another bunch of positive Mullingar on the way home, uniquely placed, too, as it created by testing backlogs. The memo has been crit- Cork, Limerick, and Statistics Office, 89,000 peo- cases in other healthcare set- before continuing to another can actually test cases. Other It sought “an urgent inter- icised by Sinn Fein health Waterford? ple call Westmeath home. tings. Pubs in the area were establishment nearby. counties are sending samples vention to ensure we can get spokesperson Louise O’Reilly. At the end of February, a This means, per capita, it has also the focus of attention for According to the Health to parts of the country where a response time on testing “Fast-tracking the imple- group of 35 students from a higher number of cases than contact-tracing teams work- Protection Surveillance Cen- there are backlogs.” equivalent to that pertaining mentation of the package of Castlepollard Community Col- every other county except ing to understand how the tre (HPSC), which has been So once again, Westmeath within the public hospital measures agreed last week- lege returned from a mid-term for Dublin and Cavan. Per virus has been spreading here. compiling Ireland’s Covid-19 seems to have fallen victim to system”. end as well as increasing break trip to northern Italy 100,000 people, Westmeath He blames the cancelled Ire- ‘High levels data, just three pubs across circumstance. This nursing home urged staffing supports and PPE with four of their teachers. has had 171 cases. The Breffni land-Italy Six Nations match the country have been linked The local HSE team said the minister to allow its doc- provision will hopefully stop Soon afterwards, one of County only surpassed its for attracting supporters to of testing to a coronavirus cluster. How- testing has been a key part of tors to take swabs and deliver the chains of transmission the pupils felt unwell. He southern neighbour last week the county when they had no will uncover ever, two of these pubs are in the response. them to local hospitals for in the nursing home sector,” had worrying symptoms. A after a huge spike in cases was game to attend. the midlands. The Sunday “The rate of illness is not analysis. It claims 40 staff she said. doctor was consulted, swabs linked to a cluster at Cavan “The second issue is a more cases Independent understands at attributable to any particu- and three residents have been Mr D’Arcy said extra sup- were taken and the boy was General Hospital. big number of people from least one of these cluster pubs lar setting and reflects wide- waiting two weeks for results. port was needed but it ap- isolated while Covid-19 test Some locals feel Dublin Mullingar went to Chelten- — and it is in Mullingar. spread testing. All protocols “The delay in getting test pears geography has a role results were pending. Contact had a role in the high volume ham last month,” he said. Half of the country’s clus- in relation to restricted move- results is directly impacting in how Covid-19 impacts the tracing commenced. of cases in Westmeath. Other There is little evidence appears we tered cases have been linked ments, isolation and contact on our ability to contain and sector. “Our local HSE team The school trip itinerary CSO data shows more than of Italians having a role in are testing to either a nursing home or a tracing are being followed,” a manage the spread of the has been with us from the did not include travel to parts 1,000 people living here com- transmission of the disease hospital. Mullingar’s region- HSE Midlands spokeswoman Covid-19 virus,” the nursing start. We have had a good of Italy that were then affected mute to the capital every day locally, but many people are more than al hospital is not home to a said. home’s chief executive wrote. relationship with them, and by Covid-19. A list of places the for work. Map data produced concerned about the role a cluster but patients are being “Testing for Covid-19 is a Another nursing home those PPE issues and other boy visited with classmates by the State’s statistics agency bumper week in Cheltenham other treated there. key element in pandemic con- in the south of the coun- problems in various parts of was analysed. It was deter- shows many of these commut- has had. Newbrook Nursing Home trol and has been implement- try, which has five residents the country have not hit us, mined he could only have ers are congregated around Westmeath is home to a counties...’ in Mullingar has confirmed it ed in these various settings.” awaiting test results, com- but they are there.” German tests and agriculture labs: their role in Covid-19 battle

÷ We are now further away from ÷Not necessarily. Taoiseach Leo German labs. As of last night, a day. At the start of last week contact tracing. At the moment, a huge global push to develop the end of lockdown than when Varadkar is adamant “there’s we have had 8,928 positive cases it was only doing a third of this 200 of these are deployed every a vaccine. It is estimated it it was first introduced. What’s no magic figure” that indicates of Covid-19 in Ireland, and 320 number because of a global day because this is deemed could take up to 18 months to going on? & when this will end, but experts deaths. shortage of chemicals needed to sufficient for the number of cases develop one that is safe to use, ÷The decision to extend will be keeping a close eye on The growth in cases is still analyse a test. It said the German in Ireland but there is capacity but companies insist they can the lockdown to May 5 was Q A hospitalisations, ICU figures and hovering around the 10pc mark, agreement helps improve here to increase this if testing have one in place within 12 recommended by public health the number of new cases that which is considered pretty turnaround times for tests. speeds up. Last week, political months. They will be helped by officials who are keen to avoid will continue to emerge. good, but any increase would be Some people have been party leaders were told 53,000 anxiety around the disease and a spike in cases which could When we get out of worrying and will put hospitals waiting two weeks for a result tests had been analysed in labs. willingness by regulatory bodies be caused by people engaging lockdown really depends on under considerable pressure. and recovered from the illness to fast-track licensing. Many in normal behaviour after how well lockdown goes for by the time they found out they ÷ Are people recovering? experts feel some restrictions restrictions are lifted. It seems our hospitals. Chief Medical ÷ Why are we sending swabs to had Covid-19. A HSE lab in ÷The Sunday Independent will have to remain in place patterns that emerge in other Wayne Officer Tony Holohan said we Germany? Cherry Orchard, Dublin, came asked the Department of Health until a jab is in place, hence the countries will have a role in will see a relaxation on measures ÷Backlogs mean some 14,000 online last week to help, and a for the number of people who urgency. determining when normality O’Connor over time, but these can be tests were sent to Germany for Department of Agriculture lab is have made a recovery from resumes here. Austria and the reintroduced if cases become analysis to ease pressure here. also boosting capacity. coronavirus. Details were not ÷ And the Leaving Cert is Czech Republic have eased their problematic again. While 1,035 of these showed a provided but there is anecdotal postponed. What happens now? restrictions recently and will be positive result, and the figures ÷ Will this help those tested get evidence of people making a ÷It is hoped that schools will watched closely in the coming ÷ How are our numbers looking? were logged by the Health results sooner? full recovery. It is also clear be able to retain examiners and weeks. ÷After some confusion last Protection Surveillance Centre, ÷In theory, it should — but that some of those healthcare rooms that would have been week, Ireland now has 8,928 they were not included in the there is currently no automated workers infected in the early available for the Junior Cert ÷ Why was there a big to stay in other parts of the Covid-19 cases. This may seem overall total announced by the process for uploading lab results. stages of this crisis are now exams. Using these resources hullabaloo over holiday homes and country increases the risk of like a significant jump from the Department of Health every day. The process has been developed beginning to return to work. means young people sitting their long weekends? them carrying the infection to previous week — we had 4,600 Its explanation was that these over the past four weeks, and can Doctors are keen to emphasise Leaving Cert can continue to ÷The important thing for new areas, or picking it up and cases a week ago — and can tests were not determined to be scale up to deal with more than that while some groups are at adhere to social distancing when health officials is to cut down bringing it home. With two bank partially be attributed to the new results because they were 2,000 new cases a day. The HSE risk most people should be able exams take place. on the number of cases linked holidays between now and the inclusion of numbers from swabs part of a backlog. They have now admits this needs to get better to make a full recovery. Students will not see an to community transmission, start of May, officials felt a need sent to Germany for testing. been added to the overall tally. but promises improvements are exam paper until restrictions cases where it cannot be to act decisively. Initially, there were 7,054 on the way. ÷ But we still need a vaccine. are sufficiently lifted. So July, determined how a person picked cases last Friday, but this figure ÷ What is happening with tests? It should also help with What is happening with that? or even August, looks like when up coronavirus. People leaving ÷ OK, but that’s it after the May did not include more than 1,000 ÷The HSE says it is now in a contact tracing. There were ÷It has been labelled the the Leaving Cert is most likely to their homes for the weekend Bank Holiday, right? positive results returned from position to process 4,500 tests 1,700 people trained to carry out modern holy grail, so there is happen. BRENDAN O’CONNOR AT HOME My diet — and the LIZ WITH urge to cheat at it LIVING BONNIN On racism, ambition, CATHY Francis Edna the gender Brennan pay gap O’Brien and climate KELLY The Loves and her change PAGE 23 LIFE of my Life LIFE foes LIVING SundayIndependent

Vol. 114 No. 42 20 October 2019 city final ¤3.30 (£2 in Northern Ireland)

The payoffs to TDs who didn’t quit politics RORY’S FAREWELL TD claims ‘phantom’ Wayne O’Connor benefited from the scheme, EXCLUSIVE earning €78,149 between them. The payments, known votes are NATIONAL politicians, in- as gratuities, are made to cluding two ministers, an MEP long-serving former council- and a high-profile barrister, lors after resigning or losing cast often have received golden hand- their local authority seat. More shakes for leaving council the gratuity payment scheme €37,195 last year in recogni- Frontbench Fianna Fail than €8.4m has been paid out seats after they were elected is applied to long-serving pol- tion of her service to the local politicians, including justice to former councillors during Philip Ryan to the Dail, the Sunday Inde- iticians who move from local authority before she became spokesperson Jim O’Callaghan the previous council term and and Cormac McQuinn pendent can reveal. to national politics. a TD in 2011. Agriculture Min- and public expenditure spokes- since the recent local elections. More than 20 TDs and New figures obtained by ister Michael Creed is in line man , have also This sum includes more than A FIANNA Fail TD at the cen- senators have been paid thou- the Sunday Independent show to receive €34,386 from the received thousands of euro €6.2m paid to former council- tre of a Dail voting controversy sands from a scheme to help Clare Daly is the only MEP scheme. Junior Minister Sean from their time on local coun- lors who lost or vacated their has claimed deputies “often” former politicians adjust to to have benefited from the Canney was paid €38,821 from cils in Dublin and Offaly. seats at this year’s election. vote for colleagues when they life after retiring from councils. scheme over the past five years. Galway shortly Kerry brothers Michael and are not in their assigned seat. It raises questions about how paid her after he was elected to the Dail. Danny Healy-Rae have also › Full story, pages 10-11 Limerick TD made the comment as Ceann Comhairle Sean O Fearghail ordered an investigation into voting irregularities. The investigation was launched after the Irish In- dependent revealed Fianna Fail TD Timmy Dooley was re- corded as voting on legislation six times despite not being in Brexit betrayal: the Dail chamber. Yesterday, Minister for Jus- tice Charlie Flanagan said the Ceann Comhairle must “act swiftly and decisively to protect the integrity of the parliamentary voting system”. TD Noel Rock DUP twist knife also criticised “the damaging EMOTION: Captain Rory Best applauds the crowd after practice of phantom votes”. Ireland lost their Rugby World Cup quarter-final match 46-14 to New Zealand in Tokyo yesterday. See Sport › Full story, pages 4 Johnson asks EU for extension in unsigned letter

Jody Corcoran policy amendment to avoid no-deal. THE Democratic Unionist BREXIT ANALYSIS — P20-23 The DUP’s view is that the Party has exacted revenge for proposed new deal between its “betrayal” by UK Prime the UK and EU “undermines Minister, Boris Johnson, who letter of request for the exten- and updated him on develop- the integrity of the Union” by last night was forced to for- sion. Mr Johnson then sent a ments in Westminster. placing a border in the Irish mally request another Brexit separate letter making clear After Boris Johnson vowed Sea, and departs from the extension from the European he does not want a delay and to not seek an extension be- principle of consent in the Union. is planning to put his deal yond the scheduled departure Good Friday Agreement. The Northern Ireland party before MPs in the House of date of October 31 — he had The UK government lost landed the fatal blow that Commons next week. said that he would rather “die the vote on yesterday’s amend- ensured Mr Johnson had no He also phoned European in a ditch” — he was legally ment by 322 votes to 306. option but to request a delay leaders last night to declare forced to request the exten- Had the DUP supported to Brexit, with DUP deputy that the letter “is Parliament’s sion after the DUP yesterday the Conservative government, leader Nigel Dodds turning on letter, not my letter”. supported an amendment the amendment would have the UK Prime Minister. Mr Johnson is reported to which denied him a clean been defeated by four votes In an excoriating attack in have insisted to the EU that vote on the new Withdrawal — and a highly anticipated the House of Commons, Mr he is “not asking” for a “deeply Agreement, in a move which ‘meaningful vote’ on the With- Dodds accused Mr Johnson corrosive” delay to Brexit. delays Brexit. drawal Agreement would then of being “weak” in his nego- Last night European Coun- In a day of high drama at have proceeded. tiations with the EU and of cil President Donald Tusk the UK House of Commons, The UK government then betraying promises made on announced he had received which saw Jacob Rees-Mogg withdrew a planned ‘mean- Brexit related to the Northern the formal request for an ex- and others avail of police ingful vote’ — but Mr Johnson Ireland. tension to the Brexit deadline. escorts, the DUP’s 10 MPs — immediately said he would Last night Sir Timothy Mr Tusk said he will now be- furious at what they regard press on “undaunted”, despite Barrow, the UK Government’s gin the process of consulting to be an act of betrayal by Mr a majority of MPs backing a envoy to the EU, sent Donald with EU leaders on how to Johnson — cast their votes further delay to the process. Tusk, the president of the EU respond. against the prime minister He said his deal was not dead Council, what was said to Last night, Mr Johnson rather than support or abstain be an unsigned photocopied called Taoiseach Leo Varadkar on an a so-called insurance Continued on page 2

BRENDAN O’CONNOR You can’t always get what you want

F we saw one thing fatigue. Just get Brexit done, forget all the bad things that Not only do we not on not-so-super was our attitude. Indeed, were said. understand the deal, we’re I Saturday, our day of before Brexit was even And somehow we’ve confused too about whose destiny on the sporting and done, we were looking to decided the sooner we move side we’re on. Two weeks political fronts, it was the the next phase, how to fix on now, the better, so let’s ago, Oliver Letwin would pragmatism of the Irish. our relationship with our get Brexit done, whatever have been a hero in this For four years, up to English brethren. A lot had Brexit is any more. And, country for delaying Brexit. about 10 days ago, nothing been said that could not let’s face it, fewer and But now, exhausted by the would do us only that there be unsaid. It was a bit like fewer people know what roller coaster, we aren’t sure. would be no Brexit — or when someone tells you Brexit is now. At this point Brexit was not ending how at least if there was, that they’re breaking up with perhaps the only people we might have wanted it to, it would be the softest of their mad boyfriend or who understand the detail but for a few precious days Brexits. Two weeks ago, girlfriend and you join in of the latest Brexit deal are there, at least it was ending. Boris Johnson was public with a bit too much gusto Tony Connelly and maybe And we were strangely on enemy number one in this about how you never liked Tommie Gorman. top of the world about that. country. them and how crazy they You can just see future After all, you can’t always But somehow, yesterday, are. A week later your friend taxation exam questions get the ending you’d like. many were tells you sheepishly they’re now: “An egg from England Just ask Rory Best and Joe rooting for Johnson to getting back together and, is sent to Northern Ireland, Schmidt. And you can go get a hard Brexit through what’s more, they’re getting it hatches into a chicken, very quickly from being on parliament. We had finally married. And everyone just grows for a few weeks, and top of the world, number succumbed to Brexit has to move on and agree to is then sent to the Republic one, to being an underdog to be processed. The chicken again. Recommended retail price of the Sunday Independent in R.O.I is €3.30 meat is then sent to England But the great thing Vol. 114 No. 42 S1 to be cooked and put into about us Irish is that even chicken sandwiches with when we’re at rock bottom, English bread and Irish we always keep our mad butter. These sandwiches are belief we’ll be back on top then packaged and sent to again soon. Beidh lá eile Ireland. Who pays the VAT ag an bPaorach. Second and who do they pay it to?” referendum, anyone? Sunday Independent 20 October 2019 10 SPECIAL REPORT

Politicians given COUNCILLOR GRATUITIES

Harris, Joe (Soc Dem) €17,094 CARLOW Hegarty, Mary (FG) €34,017 DUN LAOGHAIRE RATHDOWN Deane, Jim (SF) €17,087 McCarthy, Kieran (Ind) €25,610 Merrigan, Michael (Ind) €17,060 Foley, Denis (FG) €68,240 parachute deals Murphy, Michael Frick (SF) €17,094 O’Neill, Seamas (Ind) €17,060 Lacey, Walter (Ind) €68,240 O Cadhla, Diarmaid (Ind) €7,779 Stewart, Patricia (FG) 28,046 2017 O’Grady, Des (SF) €15,763 2019 Ahearne, Anne (FF) €31,507 Ryan, Bob (FF) €17,094 Fallon, Ciaran (GP) €15,149 2016 2018 n Murnane O’Connor, 2018 Leahy, Brendan (L) €26,410 Corrigan, Maria (FF) €25,120 Jennifer (FF) €47,995 valued at €8.4m O’Neill, Niall (FF) €8,336 2017 O’Leary, Jim (FG) €19,546 Walsh, Robert (FG) €4,172 Returned to council in 2019 2017 CAVAN Humphreys, Richard (Lab) €19,734 Brady, Damien (SF) † €34,017 Barnes, Noel (FG) €1,781 MEP, TDs and ministers benefit from scheme Cierans, Tony (L) €4,132 2016 Connell, Noel (SF) † €18,097 n Boyhan, Victor (Ind) €37,421 O’Reilly, Paddy (FG) † €75,699 Collins, John (FG) €31,047 Wayne O’Connor of payments are prominent Smith, Paddy (FG) † €51,021 Cullinane, Claire (Ind) l €8,412 WHAT ARE THE GRATUITY PAYMENTS? Kerry Independent TDs Mi- McCarthy, Owen (FF) €12,095 DUBLIN MEP Clare Daly is chael and Danny Healy-Rae. Tully, Pauline (SF) €41,536 DUBLIN CITY among a group of politicians n In order to qualify for a gratuity payment, former councillors Between them the brothers n Murphy O’Mahony, Mahon, Sean Paul (FF) €13,247 to have benefited from more must have served at least two years on a local authority and were paid a gross figure of Margaret (FF) €10,368 O’Moore, Ciaran (SF) €17,060 than €8.4m in payments from reached the age of 50. For politicians elected to councils after €78,149. Michael Healy-Rae, CLARE O’Suilleabhain, Connaith (SF) €13,880 Keegan, Teresa (Ind) €16,430 local authorities over the past 2010, the gratuity is one fifth of the annual representational who did not comment, was Refused to disclose what was paid to 2016 five years. payment — a sum of €16,891 or €3,378.20 for every year served. paid €36,481 in 2017 shortly McHugh, Ray (SF) €22,246 individual councillors. Gross amount Bradford, Paul (FG/Ind/) €18,747 Figures obtained by the It is capped at four times the annual representational payment after he turned 50 in recogni- Bourke, Patrick (Ind) €52,045 to all councillors: €297,544 n Creed, Michael (FG) † €34,386 Sunday Independent outline after 20 years on a council. For local representatives elected tion of his 12 years on Kerry McGinley, Ruairi (FG) €52,025 parachute payments paid to before 2010, another set of criteria entitles them to €714.23 per County Council. Breen, James (Ind) Fitzgerald, Dan Joe (FF) l €53,153 Mulooly, Michael (FF) €9,895 prominent TDs, Senators and year for each of the first 20 years served and €476.15 for each His brother Danny was Curtin, Christy (Ind) Gilroy, John (L) €22,443 Montague, Andrew (Lab) €46,712 Ms Daly for previously sitting year after, up to 40 years. Payments listed cover time served on paid €41,668 after more than Hillery, Michael (FF) on local councils. city, county, or town councils. In some cases a councillor 13 years on the council. n O’Keeffe, Kevin (FF) €54,390 McNamara, Tom (FF) 2018 The payments usually has served on one or more bodies. All figures are gross sums Danny Healy-Rae said he O’Leary, Nora (FG) €4,988 Quinn, Oisin (Lab) €32,534 cushion the blow for poli- and subject to taxation depending on personal circumstance. In was unaware of the scheme Nagle, Richard (FF) 2015 Corcoran, Ray (SF) €16,686 ticians who lose their seats most cases councillors have received the payment outlined. In until Slattery, Bill (FG) Michael Creed Barry, Thomas (FG) €6,588 at a local election but more others, payment is pending or has been preserved until the former told him he was entitled to the McDowell, Brian (Lab) €10,878 McCarthy, Don (FF) €4,312 than 20 former councillors councillor reaches the appropriate age. payment. A significant portion 2016 who progressed to national of this was taxed, he added. O’Brien, Tomas (Labour) €13,766 CORK CITY n O’Callaghan, Jim (FF) €22,176 politics have benefited from “I never went into politics O’Sullivan, John (FG) €16,690 Keegan, Gary (FF) €21,430 the scheme over the past five for money. If I wanted to make Brosnan, Tim (FF) €51,925 years. Among those to benefit A Sunday Independent in- Canney received €38,821 from money I’d have stayed out of Buttimer, John (FG) * €29,949 n Smith, Brid (PBP) €22,263 are two ministers. Ms Daly is vestigation has found more short- it,” Mr Healy-Rae said. Cunningham, Stephen (SF)* €17,060 Connaghan, Michael (Lab) €40,954 the only MEP on the list. than €8.4m has been paid out ly after he was elected to the A former councillor in Hourican, PJ (FG) €15,641 2015 She was paid €37,195 by to former councillors over the Dail in 2016. He declined Mayo who was found by the Cosgrave, Niamh (Ind) €23,822 Fingal County Council last past five years. to comment when contact- Standards in Public Office McGonigle, Laura (FG) * €30,621 DONEGAL year, seven years after leaving This sum includes more ed about the payment this Commission to have been in Nugent, Michael (SF) * €22,392 Bonner, Enda (FF) † Jim O’Callaghan the local authority following than €6.2m paid out to for- weekend. breach of a code of conduct O’Donnell, Lil (Ind) €17,060 €17,078 her election as a TD. She was mer councillors who lost or Fianna Fail’s Justice for elected representatives FINGAL Glackin, Adrian (SF) * elected to the European Par- vacated their seats at this spokesperson Jim O’Callaghan over land rezoning last year O’Driscoll, Tom (FF) €9,929 Coppinger, Eugene (Sol) €27,766 McDaid, James Pat (FF) * liament in May and did not re- year’s election. received €22,176 from Dublin was paid €34,008. O’Keeffe, Nicholas (FF) * €17,060 Devitt, Anne (Ind) €75,055 spond when contacted about Records obtained from City Council after he was elect- Frank Durcan, who was O’Leary, Chris (SF) €41,550 O’Domhnaill, Seamus (FF) * the payment this weekend. local authorities show how ed to the Dail. on holiday in Spain when Kavangh, Sandra (Sol) €16,910 O’Shea, Shane (SF) * €17,060 O’Neill, Barry (FG) * The payments, known much the councils paid pol- “During my seven years on he was contacted, described Loftus, Eithne (FG) 40,344 Slowey, Terence (FG) † €61,453 as gratuities, are made to iticians at the end of their I spent the parachute payment as O’Sullivan, Marion (Sol) €17,060 Lukusa, Edmund (SF) €16,910 long-serving former county council careers between 2015 all the salary I received as a “peanuts” and added he was Shields, Mary (FF) €46,444 2019 Murray, Mags (FF) €50,516 councillors after resigning or and 2019. councillor during those seven heavily taxed on the benefit. McEniff, Sean (FF) l €72,480 2016 Ni Laoi, Daire (FG) €16,910 losing their local authority The list also shows how years on constituency and “I was very happy to take it n Barry, Michael (Sol-PBP) €28,895 Ryan, John (FG) €30,302 seat. some politicians received the political expenses such as but I won’t tell you what I did 2019 In order to qualify for the benefit as they progressed newsletters, office costs, and with it,” he added. 2018 Farrell, Ken (Lab) €40,498 payment, a former councillor their careers. sponsorships,” he said. A breakdown of the figures n Pringle, Thomas (Ind) €36,629 O’Connor, David (Ind) €60,665 must have served at least two Agriculture Minister re- shows €2m was paid to Fianna CORK COUNTY 2017 years on a local authority. Michael Creed is set for a cords show Fianna Fail public Fail politicians in parachute n Buckley, Pat (SF) † €10,193 Conaghan, Francis (FF) €30,801 2018 They must have reached their €34,386 windfall for the 22 expenditure spokesman Barry payments, more than any Brown, Sean (Ind) Collins, John A (FG) €44,390 Quinn, Mick (SF) €27,251 50th birthday to receive it. years he served on Cork Coun- Cowen was paid €41,687 in other party. €8,337 Collins, Timmy (Ind) €36,133 Gratuities are paid separately ty Council. He has deferred the 2017. He did not respond when Fine Gael politicians were 2015 n Daly, Clare (I4C) to any salary but are taxable payment until his ministerial contacted by the Sunday In- paid more than €1.8m. Sinn Conway, Kevin (Ind) €17,094 McHugh, Declan (FF) €13,651 depending on individual cir- career ends. dependent. Fein’s former councillors were €37,195 cumstances. His Cabinet colleague Sean Also included in the list paid more than €1m. Clare Daly 20 October 2019 Sunday Independent SPECIAL REPORT 11

SEE SEARCHABLE MAP AT INDEPENDENT.IE

Michael Healy Rae 2016 2017 Morrissey, Tom €11,302 n Healy-Rae, Michael (Ind) €36,481 LIMERICK MEATH SOUTH DUBLIN Nolan, Dianne (SF) * Gilligan, John (Ind) €71,398 Ferguson, Eimear (SF) €17,060 Bonner, Breda (Lab) €17,079 GALWAY CITY Gleeson, Noel (FF) €61,005 Flynn, Enda (FG) €17,060 Leech, Brian (Sol) €17,079 2016 Cameron, Billy (Lab) €51,021 n Brassil, John (FF) €53,559 Hogan, Elenora (FG) €8,909 Gallagher, Michael (SF) €17,060 Murphy, Mick (Sol) €33,598 Gross amount to all councillors: Conneely, Padraig (FG) † €51,021 n Healy-Rae, Danny (Ind) Hourigan, Michael (FG) €65,716 Holloway, Jim (FG) €67,328 Nolan, Ruth (I4C) €17,079 refused to Lohan, Mark (SF) €9,011 €41,668 Hurley, Marian (FG) €17,060 Kelly, Tom (Ind) €17,060 O’Brien, Danny (SF) €17,079 disclose what was paid to individual Flannery, Pearce (FG) €17,060 Keller, Paul (Sol) €17,060 Lynch, Caroline (SF) €17,060 2017 councillors €315,657 Farrell, Mairead (SF) * €17,060 Loftus, John (Ind) €17,060 Reilly, Bryan (FF) €61,955 Coules, Nicky (PBP) €10,956 Dempsey, Tony (FF) O’Conchuir, Cathal (SF) † €17,060 Lynch, Sean (FF) €17,060 2016 Doyle, Keith (FF) Danny Healy Rae MONAGHAN n Brophy, Colm (FG) €27,171 Walsh, John (FG) † €17,060 McCreesh, Malachy (SF) €17,060 Fitzharris, Willie (FG) Crowe, Jackie (SF) † €67,481 n Devine, Marie (SF) €17,127 2016 O’Donnell, William (FG) €34,017 Ireton, Robbie (Lab) n Connolly, Catherine (Ind) €53,559 KILDARE McNally, Padraig (FF) €75,673 n Lahart, John (FF) €53,561 Pond, Joe (FF) €10,974 Kavanagh, Paddy (FG) Marley, Ann (SF) * €7,470 Aspell, Murty (FF) €10,909 2017 Murphy, Martin (FF) Byrne, Kevin (Lab) €54,059 n Gallagher, Robbie (FF) €43,429 Mythen, Johnny (SF) Callaghan, Deborah (FF) * LONGFORD TIPPERARY O’Brien, Larry (FG) GALWAY COUNTY Cronin, Reada (SF) €17,069 McEntire, Luie (FF) €79,882 Bourke, Joe (FG) † €21,316 Roche, Mick (SF) Burke, Donal (FF) €17,144 Hills, Billy (FG) €17,069 Mulleady, Martin (FF) * €51,180 OFFALY Browne, Martin (SF) † €19,411 Byrne, Niamh (FG) * Kennedy, Paddy (Ind) €38,345 Sexton, Mae (Ind) €40,477 Bourke, Noel (FF) €71,382 Carey, Catherine (SF) €17,079 2018 Larkin, Anthony (Ind) † Dolan, Dervill (Ind) €63,949 O’Connell, Oisin (SF) Connelly, Billy (Ind) €10,589 2018 Doran, David (Ind) * €25,569 Cunniffe, Shaun (Ind) €27,997 Lynch, Mark (SF) * Duffy, John (FG) * €30,070 Dooley, Sinead (FF) * Hogan, John (FF) † €34,027 2017 Kelly, Anthony (SF) Donnellan, Shane (FF) * McCabe, Morgan (Ind) €11,432 Killeavy, Brendan (SF) * Leahy, Denis (Ind) €47,110 2017 Wadding, Deirdre (PBP) Donohue, Aidan (FG) €17,144 McGinley, John (Lab) Loughrey, Padraig (FF) * €28,605 Maher, Sean (SF) €10,900 Lonergan, Martin (Ind) * €17,079 Feeney, Peter (FG) † €65,089 McKeigue, Tommy (FG) €73,530 McLoughlin, Louise (FG) * €30,615 Finnerty, Michael (FG) €27,184 Miley, Martin (FF) * O’Reilly, Martin (SF) * Ryan (Coole), Mattie (FF) † €71,447 WICKLOW LOUTH Healy, Tom (SF) * Murray, Teresa (Ind) €17,069 2018 Wood, Tom (Ind) † €72,696 Cullen, Thomas (Ind) † €71,412 Byrne, Tommy (FF) † l €32,210 Rowland, Paddy (FF) €15,565 Joyce, Des (Ind) * O’Neill, Sorcha (Ind) * 2018 Doran, Patrick (FF) † €70,751 Culhane, Richie (FG) † €25,530 Kearney, Frank (FG) † Power, Sean (FF) €17,069 2017 Fahey, John (FG) l €68,866 Fox, Christopher (Ind) * €51,713 Dearey, Mark (GP) † €31,794 n Cowen, Barry (FF) €41,687 McHugh, Tom (FG) €65,732 Former TD and junior minister O’Meara, Eddie (Ind) l €61,276 Lawless, Nicola (SF) * €17,060 Flood, Kenneth (SF) * €17,058 Enright, Eddie (FG) €8,751 Noone, Malachy (FF) Pender, Joanne (Ind) * McDonald, Mary (Ind) €17,060 Godfrey, Frank (Ind) † €50,695 O’Neill, Finian (FF) €7,473 €34,082 Redmond, Thomas (SF) * McLoughlin, Grainne (FG) €27,969 Saurin, David (SF) † €6,969 WATERFORD O’Cualain, Seosamh (Ind) €17,144 Scully, Darren (FG) * 2015 Nolan, Daire (Ind) * €17,060 Savage, Peter (FF) † €79,801 Fanneran, Bernadette (FF) Hannigan, Blaise (Ind) €23,645 O’Tuairisg, Sean (FF) † Young, Brendan (Ind) €17,069 O’Brien, Oliver (Aontu) €17,060 €4,158 Murphy, Ray (FF) † €10,909 2016 2017 Ruttle, James (Ind) €73,226 Cassidy, Alan (SF) €9,679 O’Neill, Laurence (Ind) €65,713 n Canney, Sean (Ind) €38,821 Ryan, John (FG) €51,087 KILKENNY Meenan, Kevin (SF) €53,976 O’Ryan, Michael (FF) * €33,980 Thornhill, Brendan (Ind) €17,060 Gardner, Breda (Ind) €17,060 2016 Barry Cowen Reinhardt, Sean (Ind) €27,735 Vance, Pat (FF) €73,627 Millea, Pat (FF) €75,711 n Breathnach, Declan (FF) €58,720 Whelan, Siobhan (SF) €17,013 ROSCOMMON Shortall, Maurice (Lab) €51,012 Loughran, Jim (SF) €40,854 2018 Council did not respond 2018 O’Connor, Michael (SF) €8,173 n Munster, Imelda (SF) €38,749 Roche, Mary (Ind) €64,037 2016 Sean Canney LAOIS n Casey, Pat (FF) €39,175 SLIGO Goodwin, David (FG) † €78,646 MAYO WESTMEATH Kavanagh, Patrick (Ind) l €16,724 Keaney, Hubert (FG) † €34,017 Moran, John (FG) €71,385 Durcan, Frank (Ind) €34,008 Clarke, Sorcha (SF) * €17,060 Kilgannon, Seamus (FF) † €17,079 KERRY Phelan, Brendan (FF) €54,059 Ginty, Gerry (Ind) €38,866 D’arcy, Una (SF) * €17,060 Lundy, Jerry (FF) † €51,021 Payments due to the following will Holmes, Michael (Ind) €51,012 Hogan, Paul (SF) * €17,160 not be outlined by the council until Kenny, Henry (FG) €68,810 2017 McManus, Ailish (Ind) * €10,918 the sums are received by councillors. MacManus, Sean (SF) €57,954 LEITRIM McGuire, Tereasa (FG) €29,372 O’Brien, Michael (Ind) * €17,060 Culloty, John Joe (FF) Guckian, Sinead (FF)* €65,716 Whelan, Teresa (SF) † €9,787 Lucid, John (FF) McCartin, John (FG) * €34,017 KEY McCarthy, Pat (FG) 2017 Logan, Seadhna (SF) * €17,079 Ruane, Therese (SF) €16,997 McEllistrim, Tom (FF) * denotes preserved payments n TD Mulvey, Caroline (SF) * €10,974 n Conway-Walsh, Rose (SF) €22,764 Purtill, Liam (FG) † denotes a pending payment n Senator Sheahan, John (FG) In some cases the sum was undisclosed n MEP l Deceased n Minister / Junior Minister MARK CAGNEY ON HOZIER: DANIELLA’S LOSS AND LOVE LIFE BARRY EGAN INTERVIEW JOURNEY — LIVING IS NO How travelling the What chef How will RTE PICNIC world gave model Marco really manage Apocalyptic a new lease of life thinks of its cash songs, love women crisis? and dealing with fame LIVING SEE SEE LIFE PAGE 3 PAGE 19 MAGAZINE SundayIndependent

Vol. 114 No. 34 25 August 2019 city final ¤3.30 (£2 in Northern Ireland)

Johnson ‘toned down’ Brexit stance after bomb LEADING LADY IN RED NEIL FRANCIS Philip Ryan attack in Fermanagh resulted “The Brits got a bit friend- was briefed ahead of German before or after she made the in the British prime minister lier to us after the attempt to chancellor Angela Merkel’s comments when pressed Ireland holed GOVERNMENT officials be- rethinking his strategy of murder PSNI officers,” the comments about finding an on the issue by the Sunday below the lieve a dissident republican targeting the backstop. source said. alternative to the backstop Independent. attack on the Border last week The source made the ex- However, a suggestion that within the next 30 days. However, a source said: waterline forced Boris Johnson to “tone traordinary suggestion that dissident activity could in- Mr Johnson seized on Mrs “Foreign governments don’t Sport down” his language about Mr Johnson and “the Brits” fluence British government Merkel’s comments about inform us of what they’re Ireland and the controversial became “a bit friendlier” to- policy on Brexit is sure to finding a solution when they going to say at press confer- backstop. ward Ireland as a direct result cause alarm within political spoke last week. ences and vice versa we don’t A senior Government of the dissident attack which and security circles. Taoiseach Leo Varadkar’s inform them.” source close to Tanaiste Simon was aimed at killing PSNI Meanwhile, the Govern- spokesperson refused to say if Coveney claimed the terrorist officers. ment is refusing to say if it he was briefed by Mrs Merkel › See page 2 Overrun GPs turn PAUL KIMMAGE GAA glass is always empty away new patients Sport

÷ Survey: 44pc of ÷ Rural areas are ÷ Experts raise

doctors’ clinics full hit worst by crisis ‘serious concerns’ FILM FRIENDS: Saoirse Ronan’s best pal Eileen O’Higgins takes a lead role in RTE drama ‘Dead Still’. See Page 3

Wayne O’Connor set to worsen in the immedi- EXCLUSIVE ate future. Special Investigation Over the past month, the ALMOST half of the country’s Sunday Independent contact- GP practices are operating Full report, See pages 4-5 ed 336 GP practices, approxi- at maximum capacity and mately one third of surgeries cannot take on new patients, nationwide, to gauge the num- a Sunday Independent inves- GP to seek help when they south west of the country, and ber which have shut their tigation has found. fall ill. Dublin’s commuter belt, are doors to new patients. Each Enquiries by this newspa- The Economic and Social worst hit by the GP shortage. practice was asked if they are per to doctor surgeries across Research Institute (ESRI) Patients’ and doctors’ taking on new patients, with the country show 44pc of warned that the lack of availa- groups said findings of the 148 responding “no”. those surveyed are unable bility has an impact on patient investigation show the stark When practices which were to see new patients. A small- care, leading to congested reality greeting patients in unsure of their availability er number (42pc) said their waiting rooms in surgeries waiting rooms across the are excluded, more than half doors are open for new pa- and backlogs in hospital emer- country. They said it shows (51pc) of practices were not tients to join their practice. gency rooms. the expansion of free GP care open to seeing new patients. The remaining practices “Where GP supply is low, to children and the elderly Dublin’s commuter belt did not know if they could patients may not receive the in recent years is increasing (counties Laois, Louth, Kil- take on a new patient or said care quickly or from their reg- the pressure on doctors and dare, Meath and Wicklow) has they would have to consider ular doctor,” ESRI researcher making the profession less the fewest available GPs, with an application before making Brendan Walsh told the Sun- attractive for new entrants. 56pc of practices there unable a decision on registering a day Independent. They added that with 700 to take on a new patient. Half person seeking medical care. “If patients cannot join a GPs expected to retire in the of the doctors in Dublin’s Experts have warned these GP list locally, they may be coming years, coupled with suburbs and commuter towns constraints negatively impact forced to travel long distances the expansion of the free GP cannot take on a new patient. how doctors are able to treat for care, or use care from children under-six Leinster and Munster also current patients. It also makes Department to receive care.” to children under-12 in the it harder for those without a Rural areas in the east and next three years, the crisis is Continued on page 4

BRENDAN O’CONNOR The G7 back-to-school blues

T’S back-to-school outgrown his uniform, has stands next to the helicop- Bolsonaro has gone down day at the G7 Inter- stubble and looks far too old ter shouting. All that can the back of the class and national School in to be in school. “You’re back be heard above the noise is trying to set fire to the Biarritz and the class again, Shinzo?” asks Mrs are random phrases: “…A desks. I are all somewhat Merkel. “How many years is great, great friend of mine… Just then, everything giddy after another exciting it now?” I know we’re gonna get on is interrupted as a scatty summer. The other pupils “Thirty, miss, 30 years great… Nasty woman… I am looking boy with his shirt are excited to have a new and still I’m here. Nothing the Chosen One…disloyal hanging out and a catapult boy in the class this year. ever changes. Ever since Jews…” in his pocket blusters into Swotty Emmanuel and Mrs that massive growth spurt “Trumpy. Why do you the room muttering, “f**k Merkel, the teacher, have 30 years ago, it feels like I’ve always stand next to the business”, then, “Oh. Hello met the new boy already so just stagnated.” helicopter shouting?” asks chaps. So sorry. Am I late? the others are asking about “And you were such a Mrs Merkel. Oh hello, Trumpy! What him. “What is he like?” asks promising pupil back then, “I like to keep the engine have you got for lunch? Sloppy Giuseppe. “What do Shinzo,” Mrs Merkel says running at all times,” says Fancy trading with me?” you care?” says Justin the sadly, “We thought you were Trumpy. “It’s not as if we’re Then British Boris goes to Jock, “You won’t be here for the future.” short of gas, is it? Anyway, get down on his knees in long more anyway. I heard Just then, there is an un- we flew over a place on the front of Trumpy, but Trumpy your parents can’t pay the bearable noise as a helicop- way down here. Big tower grabs him in a handshake. fees anymore. Does my hair ter comes crashing through sticking up and very well-de- The two of them hold it for look good? Anyone want to the ceiling and lands in the signed streets, very neat and about 23 minutes, getting take a back-to-school selfie middle of the classroom. tidy layout. I like that. Pilot increasingly red in the face. with me? Hey! I know! Let’s “Oh God,” they all say. said it was called Paris. Who Boris’s eyes are popping all go jogging and make a They keep hoping Trumpy do I talk to about buying it?” out of his head. But then viral video!” wouldn’t come back to “Who’s that with you in Boris sees one of the others A Japanese boy enters the school each year, but the helicopter, Trumpy?” the rooting in his schoolbag. He the room. He seems to have he always does. Trumpy others ask. “Oh, these are breaks off the handshake, two buddies of mine. This is shouting, “Oi. Get off my Vlad from Russia and this is f**king laptop.” Recommended retail price of the Sunday Independent in R.O.I is €3.30 Bolsonaro. Say hello to my “Mein Gott,” says Mrs Vol. 114 No. 34 S1 leetel friend!” Merkel to herself, “To think Mrs Merkel looks cross. these boys could be in “Trumpy, you know that charge of something some Vlad has been expelled and day”. And then she calls he’s not welcome back and… them to order. “OK, class. hang on a minute. What’s Simmer down. Now what your other friend doing?” should we talk about…?” Sunday Independent 25 August 2019 4 NEWS

SPECIAL INVESTIGATION: DOCTORS SURVEY Nearly half — CAN YOU TAKE ON NEW PATIENTS? County by County

County Yes No of GPs have County where 50% Carlow 20% 80% or greater said yes Cavan 40% 40% County where 50% Clare 36% 36% or greater said no Cork 47% 38% no room for Donegal 57% 29% Dublin Central 83% 17% Dublin County 50% 50% new patients Galway 60% 16% Kerry 40% 53% Kildare 40% 53% Thousands on waiting lists as books closed Kilkenny 0% 75% Laois 0% 100% continued from page one Leitrim 100% 0% showed poor availability. WE MAKE 350 PHONE CALLS TO GET Limerick 30% 52% When Dublin is excluded from Leinster, fewer than a NATIONAL PICTURE ON HEALTHCARE Longford 20% 80% third of doctors (32pc) there confirmed they have space for THE Sunday Independent details. “Is it for yourself? Louth 18% 64% new patients. made more than 350 Who am I speaking to? According to our survey, phone calls to GP practices Where are you living? Are Mayo 46% 54% no doctors contacted in Co over the past month you a private patient or Laois can take on new pa- to shed light on the medical card holder?” Meath 36% 64% tients. In counties Carlow and availability of doctors in To deal with such Longford, 80pc of surgeries every community across questions it was necessary Monaghan 50% 25% responded “no” when asked the country. Our aim was to exchange information. Offaly 20% 40% if they were taking on new to demonstrate what Our undercover patients. In Kilkenny, 75pc of issues patients encounter journalist posed as Roscommon 50% 33% surgeries said they are full, when trying to access somebody who was new with the remaining practices medical care. to the area. He was a Sligo 17% 67% surveyed asking to assess Each practice was prospective private patient prospective patients before asked: “Are you taking on looking to register with a Tipperary 31% 54% registering them. More than new patients?” In some local GP practice. half of GP surgeries in Tip- cases we were met with This element of Waterford 40% 20% One third of GP practices nationally were contacted and asked if they perary (54pc), Kerry (53pc) a straight response. When subterfuge was justified were taking on new patients. This sample size was replicated on a and Limerick (52pc) cannot we were told “no” there as the only accurate way county-by-county basis and sought a geographical spread in local areas. Westmeath 30% 50% see extra patients. would often be an apology. of verifying the response The ICGP’s “find a GP” tool was used to identify 1,030 practices and the The Irish College of Gen- Sometimes, another a member of the public 336 survey respondents. Wexford 50% 20% eral Practitioners (ICGP), the practice would be would receive. The Responses were broken down into four categories, including; “yes”, “no”, professional body for general suggested by the person investigation was carried and “don’t know”. The fourth category included cases where practices Wicklow 62% 31% asked for the doctor to assess a prospective patient or where patients practice, said a “perfect storm” answering the call. When out in a manner similar to were asked totofillfill an an application application foformrmtotobebe assessed assess bybystastaffffbebefoforereofoffeferingring National Totals 42% 44% is brewing that will force fam- we heard “yes” this would a secret-shopper survey. aa decision decision on onreregisteringgistering people people with with thethe pr pracactice.tice. ilies to attend overcrowded be followed by some chat Not every call to a emergency rooms or travel about opening hours and practice was successful. In greater distances to see a how to register before some cases the doctor was REGIONS Total of those that gave a "yes" or "no" * doctor. our reporter resisted away, out on call or nobody ICGP spokesman Dr Liam disclosing personal details was available. However, on MUNSTER CONNACHT ULSTER LEINSTER Twomey, a GP in Wexford, said and politely brought the 336 occasions a Sunday doctors are under increasing conversation to an end. Independent journalist time constraints when seeing In other instances the spoke to somebody and patients: “GPs have noticed an practice sought personal posed the question. YES NO YES NO YES NO YES NO increasing trend of patients at- tending out-of-hours services 49% 51% 61% 39% 63% 37% 42% 58% in evenings and weekends to be seen by a GP, and it means sustainability of general prac- FEMPI [Financial Emergency that some have to attend over- tice. The agreement includes Measures in the Public Inter- crowded A&E services in local proposals to extend free GP est] cuts, get more practice hospitals when they cannot care to children aged between nurses in surgeries to relieve access a local GP. six and 12 on a phased basis, the pressure GPs are under ‘Perfect storm’ brews on medical front “We are entering the per- starting next year. and give them access to proper fect storm: a growing pop- “The agreement will also diagnostics and facilities.” ulation with fewer doctors, allow for additional measures More than half of the GPs against a background of great- for GPs in rural areas and in in 14 counties are already op- HE phone rings four A healthcare crisis is looming any medication they may be population,” ICGP er complexity of care, greater areas of urban deprivation. We erating at maximum capacity. times before it is mer- using, their family’s history spokesman Dr Liam demand, and a Government are now providing a signifi- In just one county, Leitrim Tcifully answered by a as GPs close their books, of medical problems, if they Twomey said. policy to expand free GP care cant number of GP training — which has the fewest num- kind, compassionate voice. smoke or drink, have health “We are entering the despite the lack of doctors to places. I have no doubt that ber of surgeries and smallest Soon the woman’s tone turns with a shortage of doctors insurance and even if they perfect storm — a growing meet growing demand.” these new measures and this population — did all the GPs regretful. willing to take on the vital are right or left-handed. They population with fewer The ICGP called for a dou- new funding will help ensure surveyed say they had capacity “I am sorry,” she says, then promise to report back doctors, against a backdrop bling of the investment in young people continue to to take on more patients. “but we are not taking on role, finds Wayne O’Connor when they have reached a of greater complexity of primary care and an increase enter the profession,” he said. In Connacht, one third new patients at the moment. decision after assessing the care, greater demand in the number of GPs being Fianna Fail health spokes- (33pc) of practices surveyed Our books are closed and on solid ground because those already associated application. and a Government policy trained every year. person said said their books are closed there are 50 people on our almost every second practice with another GP. However, more often that to expand free GP care Irish Patients’ Association “years of failed Government for new registrations. More waiting list.” (44pc) is shut to new Staff regularly asked if not a compassionate voice despite the lack of doctors director Stephen McMahon policy” was contributing to than half (52pc) can take on a The Sunday Independent patients at present. This we were a private patient returned a simple, “No, I to meet growing demand. said this pressure impacts the shortage. patient. Sligo fared worse here is not keen to become creates problems that spread or medical card holder. am sorry,” when asked if the Ireland has 68 GPs per those already registered with Recent research by Trinity with two thirds of practices number 51 and asks if she through the health system. We were told medical card doctor can see a new patient. 100,000 people, compared a doctor, as well as prospective College shows the introduc- surveyed (67pc) saying they could recommend another Over the course of the lists were full but there was The Irish College of to 110 in Canada and 120 in patients. A shortage of doctors tion of free GP care to un- were full. doctor. She suggests one, but Sunday Independent’s limited room for new private General Practitioners (ICGP) Australia.” threatens how thousands of der-sixes four years ago led In Ulster, 52pc of doctors it is 25km away from where inquiries to 336 GP practices patients. fears the problem is set to Stephen McMahon, of the people will have access to a to a 28pc increase in practice have the ability to take on the enquiry was made. nationwide, we encountered Other doctors have a get worse. Some 700 GPs Irish Patients’ Association, GP in future for routine ap- visits by that age group. additional patients. Just 30pc Concerns voiced by rejection 148 times. vetting-type process in place are due to retire within the believes Irish doctors pointments and procedures. “This is a crisis,” Mr Don- said they are full. the Economic and Social In other cases, this where they seek to assess next seven years, it says. It working in these countries Responding to the investi- nelly said. “Doctors have been Nationally, 8pc of doctors Research Institute (ESRI), newspaper was told it was a prospective patient’s estimates 300 new doctors must be tempted home and gation, Health Minister Simon treated with contempt since said they would like to assess as well as doctors and not possible to register needs before committing to must come on stream every new graduates encouraged Harris said a programme of in- Fine Gael came into power. It a patient’s healthcare needs patients groups, that people with particular doctors if registering them with their year to deal with the crisis. to stay. “There is a looming vestment and reform is under is about time there was mean- before agreeing to register will be forced to travel long you were already affiliated practice. They offer future Just 190 are going into crisis ahead with far more way to address the GP crisis, ingful engagement with GPs. the person with their practice. distances for medical care with a GP nearby. In most patients an appointment, training this year. implications for the health referencing a new €210m “There are ways to address Another 6pc of practices did because of a GP shortage are cases, this is because there or send forms seeking “We don’t have enough and well-being of people agreement with the Irish Med- this. They need to start with not know if they were able to very real. This investigation are people on waiting lists information about the GPs for the number of than Brexit,” he warned. ical Organisation to ensure the accelerating the reversal of take on more patients. proves those fears are built who must be prioritised over person’s medical history, patients and the growing “It is an ominous sign.” 25 August 2019 Sunday Independent NEWS 5

When Dublin Central is exluded * How can we cure the growing Total of those that Assessed by doctor gave a "yes" or "no" before Don't confirming know problem of patient refusal? 0% 0% YES NO 20% 0% 48% 52% 18% 9% We need to retain our when the under-six medical work-shy, but exceptionally quicker part of the solution. *excluding “don’t knows” and doctors card was introduced. Many resilient individuals. Many There is overwhelming 8% 8% who sought a patient assessment newly qualified GPs, mistakenly believe it is OK see how poor public hospital international evidence that and there are ways that to use the co-op as a GP services for their public the best health outcomes 7% 7% service, but it isn’t. patients are. They find gross happen in societies with When all of Dublin it can be done, writes Evidence clearly indicates discrepancies in hospital strong primary care, freely 0% 0% is exluded * Dr Brendan O’Shea the value of continuity and care between public and available, delivered by Total of those that managed care for chronic private patients repugnant. adequate numbers of GPs 0% 0% conditions. The co-op is not They do not see themselves and practice nurses. The gave a "yes" or "no" RE you among in our healthcare system, designed for these. So, as lining up for a life of shoring NHS is an excellent example 20% 4% The Refused, a where the public patient is the influx of people to the up this. GPs understand our of value for money, equality private patient actually and systematically satellite counties continues, incomes are reasonable, and better health outcomes. 7% 0% who cannot advantaged over the private the pool of available GPs but staggering volumes of If Government wishes Afind a practice patient. This privilege is YES NO is static. Some of this is work, chronic uncertainty to extend free GP care to 0% 7% to register with? There of course illusory. The GP because young GPs leave regarding hospital care and under-12s, which many 13% 13% 48% 52% are many such individuals has the right to take such after training. We have a seemingly impervious regard as desirable, it in villages and towns individuals off their list serious difficulty attracting and, at times, hostile system is important to ensure 0% 0% *excluding “don’t knows” and doctors nationwide. after six months, which younger colleagues. Co of outdated management, adequate funding, so who sought a patient assessment It is a concern that nearly many do, adding to particularly in public practices can recruit and 0% 0% half of general practices are patient churn. ‘Many believe administration, are factors accommodate more GPs closed to people seeking to This all adds to the in their decisions to leave. and nurses. If not funded, 17% 0% register and this impacts stress on GPs in clearly that it is OK to There are practical weaker practices will close, NATIONWIDE those who have a doctor as overburdened practices, solutions which can be and stronger practices may 0% 0% well as The Refused. particularly in remote rural use the co-op implemented. It takes increase fees to a shrinking Total of those that There are three GPs and inner-city deprived more than nine years to pool of private patients in 9% 9% gave a "yes" or "no" * at our own practice in Co practices, and has helped as a GP service train a GP. When the public order to survive. Kildare and we have had create the underclass of hospital gulags are sorted The present limited 0% 0% to again close our doors to refused patients who, by — but it isn’t’ out — and they must be — extent to which this new patients for safety and default, increasingly rely that will help retain GPs. important Sunday 0% 0% workload concerns. Working on out-of-hours GP co-ops, Kildare has 44 GPs per On completing training, Independent survey days are book-ended by themselves staffed by tired, 100,000 population. It is very well qualified and indicates GPs are ‘vetting’ 25% 0% earlier starts at 8am and overworked GPs. 68 for Ireland and ranges mobile young GPs enter a patients is encouraging, but 20% 20% struggling to get out by 7pm. In Co Kildare, where we between 90 and 110 for the highly competitive global more workload is likely to Lunch is a sandwich over have a busy, well-organised NHS and Commonwealth jobs market. They are see more practices turning 0% 17% paperwork and an incessant GP co-op for out-of-hours health systems. snapped up. They are not away people with more NO YES mix of stressed busy clinics, services, you can usually add I was directly involved naturally greedy individuals, complex health needs, which 17% 0% phone calls and frequently on two or three additional in postgraduate GP but income and workload would be deeply regrettable. futile administration. sessions per month that training between 2003 and here must be competitive The volume of The Refused 0% 15% Primary Care bring the working day to 2015. Younger colleagues with the UK, Canada and will, thus, grow. 51% 49% Reimbursement Service 11pm or into the weekends. expressed serious Australia to stem People unable to find a 10% 30% (PCRS) administration is Co-op sessions have difficulty with the the loss of new practice need to clearly tell over-represented in this, higher proportions of unremitting grind GPs. their public representatives. 0% 20% with endless repetitious serious acute consulting, of daily practice. Our If you are among The letters and forms validating with unfamiliar patients. They spoke of system Refused, you might also 20% 10% the individual’s medical During the last decade, their trainers as is ascertain their knowledge needs. When a patient visits increasing numbers we see exhausted and regarding Slaintecare — 8% 0% a GP using a medical card, it on co-op duty are those who chronically plans to reform healthcare *excluding “don’t knows” and doctors who is the PCRS which pays the have recently moved into understrength into a single-tier system in 8% 6% sought a patient assessment GP for most services, and Co Kildare but are in GPs, which patients are treated payments are largely capped unable to find a but seriously on the basis of need rather irrespective of the number local practice. understrength in than ability to pay. Ask your of consultations. Many include practice nurses. public representative what is Medical card holders young Increasing their commitment to it. DUBLIN DUBLIN LEINSTER can’t easily be among The families volumes Access to primary care City and county Commuter counties Dublin excluded Refused, since the PCRS has with higher of is regarded as a right the right to assign medical medical selected throughout Europe, but not card patients to the lists of need. This work in here. If you are among The YES NO YES NO YES NO GPs who have otherwise trend was general Refused, your local political closed their practice. This markedly stressed. practice representatives need to 55% 45% 39% 61% 36% 64% is frequently exercised. accentuated As well- can be better done by know of your existence. It is a paradoxical and with increased trained GPs, practice nurses. This would *excluding “don’t knows” and doctors who sought a patient assessment almost unique instance paediatric consulting young GPs are not be a less expensive and Dr Brendan O’ Shea is a GP