GP shortage delaying hospital discharges for wards of court, judge told

Patricia Hickey, general solicitor for wards of court, told Mr Justice Peter Kelly on Monday she is experiencing difficulty sourcing GPs for wards who are ready for discharge from hospital. Nursing homes generally require that a ward is under the care of a GP before accepting them but there is a mounting problem because of full GP lists in some nursing home catchment areas, particularly outside Dublin, and reluctance by GPs to take on additional patients. 

 

One ward has been waiting some eight weeks to get onto a GP list, delays have been experienced in other cases and the problem affects both private and public patients. 

 

The latest case concerns an intellectually disabled man for whom a nursing home bed has been found but who does not have a GP in the nursing home area. A ward of court for many years, the man was removed to hospital last January by court order after having been found living with his elderly sister in “substandard” conditions at their home. The house, in a rural area, was described as cold, dilapidated and neglected, with mould on the walls and insanitary bathroom and toilet conditions. 

 

Concern about his situation and about refusals by his sister to permit social workers access to the house was expressed by a senior social worker in a letter to the wards of court office last October. 

 

Mr Justice Kelly directed that various steps be taken, including appointing Ms Hickey as joint committee with the man’s sister to represent his interests and directing his removal to hospital. The man’s sister is still at home but Mr Justice Kelly, having been told there are also concerns about her capacity and living skills, has directed an inquiry into whether she too should be made a ward of court. 

 

When the man’s case returned before the judge on Monday, Ms Hickey said a nursing home bed has been identified for him but it had not proven possible to access a GP in the relevant area. She had been told there is an “acute shortage” of GPs in the particular area, she said. 

Until a GP is found, the man will have to remain in hospital and she wanted a two-week adjournment to continue the search for a GP or see if she could find a way around the problem, she said. 

 

Mr Justice Peter Kelly said it used to be a problem getting a nursing home bed but that had resolved and the latest problem was a lack of GPs. 

 

If the man is fit for discharge, he should be out of hospital given the pressures hospitals are under and because hospitals can be sources of infection for elderly people, he said. 

 

He adjourned the matter for two weeks, and said Ms Hickey had liberty to apply if there was a proposal to solve the problem and wished her luck in the search for a GP.