According to a study published in the Irish Journal of Medical Science, less than one per cent of the cases received by many of the country's GP co-operatives are emergencies.

The highest incidence of emergency was reported at just 10%.

Four of the 11 co-operatives surveyed also said they dealt with no calls from ambulance services, while one co-op received 232 such calls.

The study, which was conducted in 2004 by the Department of General Practice in UCD, found that there was "a basic uncertainty" about the extent to which co-ops should be collaborating with emergency services.

Interviews with GPs revealed that, while they were all prepared to deal with emergencies that might arise during consultations at the health centres, they had very mixed opinions about "responding to collapses, road traffic accidents or other emergencies outside the scope of care for patients registered with the practices."

Some of the GPs had serious concerns about being perceived by health boards as "a stop-gap measure" to fill in for underresourced ambulance services. Others reported extreme stress after encountering serious emergencies.

According to Dr Tim Gleeson of Lukedoc . . .

an after-hours service for patients in Dublin . . .

while many co-operatives don't deal with traumas, they do help the A&E departments by looking after all the minor injuries, aches and pains that would otherwise be clogging up the hospital system.

Gleeson runs a general practice in Rathfarnham, Dublin, but in 2004 he and a number of other doctors situated around St James's and St Vincent's hospitals decided to set up 'Lukedoc' for patients in that catchment area.

They linked up with St Luke's hospital in Rathgar, which operates a day service only and were given permission to operate out of there from 6-10pm Monday to Friday and all weekend.

"We recruited up to 40 doctors from around the area who were at an equal distance to St James's and St Vincent's, " said Gleeson.

"These hospitals are always too full and so on our own initiative, we set up an after-hours service. The health board only came on board after we had it all sorted and we had a lot of difficulty getting funding from them for staff.

In fact, we very nearly didn't get the funding."

Gleeson said that the next step was to expand Lukedoc to ensure there would be a 24-hour GP service for patients in the area, meaning the A&E department would no longer be the only option for people at nighttime.

"The big issue for us is whether the state will fund overnight services from 10pm to 8am, " he said. "The rest of the country has done that and I think it's been an excellent service. But it has to be properly resourced and properly paid. No doctor can go out on a limb, working all day and night with no support and still give proper care. Let's see the money first."