HALF of GP practices in Co Fermanagh are expected to close within the next year as doctors struggle to meet demand, a union chief has warned.
Dr Tom Black, chair of the British Medical Association's GP committee in the north, also said that soaring numbers of family doctor practices in Belfast are reporting pressures similar to their rural counterparts, with "multiple" on the brink of collapse.
The Derry GP was speaking following the union's GP committee meeting yesterday, which comes a fortnight after the closure of Roslea surgery in Co Fermanagh, leaving the village without a doctor for the first time in 100 years.
Villagers must now travel 30 miles to the nearest surgery in Lisnaskea while other small practices are merging in bigger centres.
It has also emerged that a local pharmacist is offering a skype service to those urgently seeking a GP consultation, where a private doctor assesses you face-to-face online for £46.
"Seven practices in Fermanagh went to two in the last few weeks. One practice call Maple Healthcare in Lisnaskea used to be four over a fortnight ago." said Dr Black.
"But we expect another five to close in Fermanagh over the next 18 months - so that will be be half the practices in Fermanagh closed within the next year to year-and-a-half.
"Ultimately we expect Fermanagh to go down to three if things don't change - and that's just Fermanagh. At the meeting I asked the representatives to count me off who was in trouble in their area. Each of them had multiple examples.
"I was surprised that the east (practices in Belfast and surrounding area) has so many mergers and are at risk of collapse in the next 12 months. The big problem in Belfast is that the smaller practices can't cope with the workload and reduced workforce."
Dr Black also revealed alternative options being explored in the event of GPs resigning from the north's health service.
In December, hundreds of individual GPs signed undated resignation letters, expressing their frustration that they had the lowest funding in the entire NHS despite having the highest workload and smallest workforce.
A "significant number" have forwarded additional letters over the past four months, according to Dr Black.
"I don't want to appear over-confident but I suspect we are moving towards a critical mass of 60 per cent of practices signing letters over coming months - it will be then that will organise locality meetings to reach agreement and move forward to action."
Alternative potential "actions" thrashed out yesterday was a service modelled on the Republic's GP system, in which patients are charged €50 for an appointment or a completely privatised service.
Another option is based on the Gurnsey model, where patients pay to see their GP but hospital care is free.
"My GPs are very clear, they want to stay in the NHS...but if we sit and do nothing, we're all going to become another Roslea," he added.
