GP services can't be sustained warns top Doctor
It comes as new figures show there are less active GPs across NI but the number of registered patients has climbed in the past decade.
Last updated 6th Jun 2025
A top doctor in the north west says General Practice services cannot be sustained under current pressures.
It comes as new figures show there are less active GPs across Northern Ireland, but the number of registered patients has climbed in the past decade.
As of the 31st of March 2025, there are 305 active GP practices in NI, which is a reduction of 7 practices since 2024 and a drop of 45 (13%) since 2014.
Meanwhile the average number of registered patients per practice has increased, by over 23% since 2014, from 5,500 to 6,777.
Dr Tom Black is GP at Abbey Medical Practice in Londonderry and the former Chair at the British Medical Association.
Mr Black said: “It's very difficult to get your patients sorted. So, they can't get in through casualty. We used to admit them directly to the ward. You can't do that anymore. You used to get them seen urgently at outpatients. That's very difficult and to wait for a routine appointment now is five, six years.
“People who used to get their gallbladders out or their hip replacements done or their knee replacements or their tonsils out, just don't get sorted anymore and they just keep coming back repeatedly to us.”
The latest figures are from the General Medical Services for Northern Ireland, Annual Statistics 2024/25.
It shows there were 2,067,000 individuals registered with a GP practice on 31st March 2025. The Health Trust with the largest patient population was Belfast (441,000) while Lisburn and Castlereagh had the lowest number of registered patients (124,000).
Of the new (first time) patients registered in Northern Ireland during 2024/25, almost one quarter (24%) were non-UK nationals, 2 percentage points lower than in 2023/24. This proportion of non-UK nationals ranged from over one third (36%) in the Belfast LGD to 12% in Lisburn and Castlereagh.
Mr Black added: “We need more money in the health service, and we've put more money into the health service. I'm the first one to recognise that, but it's not enough because there are more old people with many diseases than we can’t cope with.
“I think that what that teaches us is that we’re trying to do too much now. It's too easy for me to say, oh, put more money into the health service. We're already putting a lot into it.
“The next step, I think, is we should probably focus the resources we have on the people with the greatest need. And I think that's what's going to have to happen now.
Mr Black said another issue facing the workforce is workload pressures are turning GPs away from Northern Ireland and creating problems in recruitment.
He added: “There's not enough funding for patients to be seen by GPs.
“I can't recruit. Nobody wants to come and work for me because it's too hard and it's not well enough paid. Now forget about the pay, just focus on the hard work.
“I appreciate it's in the Bogside and Derry and it's a high deprivation area. It's a busy, very difficult practice, but that's okay. I enjoy that and my partners do, but nobody will come and join us because the work is too hard.
“When we tried advertising and interviewing, all the candidates took jobs across the border, in Buncrana, in Moville in small towns in Donegal that GPs in Derry would not normally have gone to.
“When you ask them why, they say it's twice the money for half the work. And that's the competition that we have.
“The problem we have is that the minister says he's no money and he just spent 215 million on waiting list initiatives, which I think is a good thing to spend money on. But I think if you had been a good housekeeper, you would have fixed general practice first.
The minister said there would be a package of £9.5 million in additional core funding for services for GPs.
A DOH spokesperson said, “It is a matter of regret that the Department has not been able to reach agreement in relation to the 2025/26 GMS contract. The Minister remains open to discussion as to how best to secure the future of general practice so that it can remain a central part of primary care services now and in the future.
“The £9.5m associated with the 2025/26 GMS contract represents additional investment in core GP services, with no ‘strings’ attached in terms of additional workload, or no requirement for additional patient consultations.
“Total investment in GP services this year will be more than £414m. This includes pay uplifts from last year, and the recently announced investments in MDTs which will go directly to support GPs in meeting the needs of their patients by expanding capacity in Practices. The Department has also announced investment of £2.9m in GP Elective Care, which will benefit GPs directly while meeting the needs of patients.
“The Minister has also stated his intention to see the pay recommendations from the recent DDRB report implemented for 2025/26 in full, which will see a further £11.5m invested in GMS.
“Given the extreme budgetary challenges facing the Department, however, the Minister has made clear to the BMA that the £9.5m contract offer, which will provide support directly to GP practices in Northern Ireland, was the best and final offer for 2025/26.
“The Department remains committed to engaging with GPs on how General Practice can play an integral role in the delivery of primary care services in the future, as part of the Minister’s agenda to ‘shift left’ both in terms of where in our system care is delivered, and how resources are allocated to fund delivery of that care.”
Read More:
Nesbitt accused of 'flippant' and 'dismissive' attitude towards GPs' funding concerns
How to listen to Downtown Radio: