A CO ARMAGH doctor has spoken publicly about how she feels "bullied" by the Department of Health after receiving a letter "urging" her to work in a GP Covid Centre - or else face consequences.
Dr Gail Pickering, who runs a busy practice in Tandragee, said correspondence sent a fortnight ago on behalf of the most powerful civil servant in health service, Richard Pengelly, left her "sick to the core" and fearful about her job security.
The experienced GP also questioned the logic of continuing to run the Covid centres, when so few patients are attending with some doctors being paid £400 for a four-hour shift in which only one to two suspected cases may be seen. No testing is carried out at the facilities.
With almost 4,000 patients on her books, Dr Pickering said she was unable to provide cover at a time when her caseload was mounting, particularly with suspected cancer patients and those struggling with addiction problems.
She also pointed to comments made last month by Health Minister Robin Swann, who confirmed that participation in the centres was not a "contractual obligation".
In an interview with The Irish News, Dr Pickering said the department's management of the crisis had impacted on her mental health when "she just wants to get on with her work".
Her decision to speak out comes two months after 130 GPs signed an open letter outlining their "serious concerns" about continuing to staff under-used Covid Centres during severe NHS pressures.
"I'm a single-handed GP. It’s not out of choice, my partner retired on medical grounds three years ago. It’s impossible to recruit because there's just no GPs looking for partnerships at the moment," Dr Pickering said.
"From my perspective, if I go to work in a Covid Centre throughout the day, who is going to look after my patients? I would have to close the doors in my own practice to go and work in a centre where they're seeing one patient every four hours maximum.
"We’ve managed our own patients really well. We've either seen them in the carpark or spoken to them on the phone or Skype. We have a couple of external rooms in our practices where people can come in but not go round the whole building. We deep clean them after every patient. I’m sure I’ve spent £1000 to date on PPE because what came from the board was totally inadequate.
"I've a steady locum who helps me a couple of days a week and two advanced nurse practitioners. But we have a significant number of patients and our everyday bread and butter stuff has massively increased. We've had a lot of folk with alcohol and drug issues. We've also had people with gambling issues. All of those things are really hard to get dealt with when people aren't being seen.
"So when the correspondence from the department came through, I actually felt sick to the core. It's really impacted me health wise. I just don’t understand when the Covid Centres are practically shut because there’s no-one going to them, why on earth they would still try go and force you to work in them.
"At the beginning, when all of this happened I didn’t want to put my head above the parapet. I just wanted to get on with it. But now I feel very differently. I have been left feeling bullied and intimidated."
The July 17 correspondence follows a letter sent by Mr Pengelly in April which led to an outcry when he warned that GPs who failed to work shifts at centres could risk "variations" to their contracts.
The latest letter to Dr Pickering states: "I would urge you and your colleagues to reconsider the decision to not participate in the Covid-19 Centre rota.
"If your practice continues to fall outside the agreed regional arrangements we may need to review your individual arrangements in order to ensure your patients have access to the same quality services as patients from participating practices."
The correspondence adds she can "engage" other doctors to cover shifts on her behalf.
However, the Co Armagh medic said trying to get a temporary locum GP was problematic.
"I was told the Covid shift could be allocated to me but then I could phone locums to engage them to cover my shift and I would have to pay them to do that. If the person didn't turn up, it was still down to me," she said.
"Also, some locums do not want to come and work a whole day at my practice for the same money they can get for four hours at a centre. So it's actually killed the whole locum scene as well."
Dr Pickering has formally responded to the department saying she will continue to work at her practice.
"One size does not fit all. I understand they had to find a way to manage the pandemic at the outset but this has been so badly handled I fear for the future."
A department spokesman last night said they were "disappointed" that "anyone would say that they feel bullied to continue working in Covid centres given the efforts it has made to work closely with GP leaders and support practices throughout the pandemic".
"All GPs are strongly encouraged to support Covid centre rotas on an ongoing basis as the overwhelming majority of practices have done to date," he added.
