There are now fewer GPs in Northern Ireland than in the 1950s, the British Medical Association has said.
Warnings over the future of general practice were given to Stormont’s health scrutiny committee amid claims that droves of doctors could leave the NHS if an urgent rescue package is not rolled out.
Describing the situation as “intolerable”, Tom Black, chairman of the BMA’s GP committee, highlighted major issues with workload, workforce and funding.
He said: “It is a very, very difficult time and it is as bad as we’ve ever seen it.”
There are 950 full-time GPs working in Northern Ireland, but 25% are over 55 and expected to retire within the next few years, MLAs were told.
Pressures have dramatically increased in the last 10 years and a typical day now includes 43 patient consultations as well as writing prescriptions, lab tests and dealing with letters.
Dr Black said: “No other professional would be asked to perform 43 consultations. It is extraordinary pressure.”
There were also claims that GP services in some rural areas could implode within five years.
Fermanagh is likely to be worst hit, with grim predictions of a drastic drop in the number of practices from 17 to five, meaning some patients may have to drive up to 40 miles to see a medic, the committee heard.
Small practices in Belfast are also under threat.
Dr Black said: “We really cannot stop this. It is happening now.
“This might sound cataclysmic, apocalyptic, but it has already happened in the USA where three-quarters of family physicians have disappeared.”
A much-anticipated report on reforming the health service is expected to be published next week. It follows a review by a six-person panel led by Professor Rafael Bengoa.
According to Dr Black, the BMA has devised radical contingency plans to protect services because GPs are not confident that recommendations will be implemented by political leaders.
“If this report is not implemented, we will move outside the NHS,” he said.
“As a union we will be collecting undated resignation letters and 12 months from now we could be outside the NHS.”
Health committee chairperson Paula Bradley said GPs had been facing crisis for years.
“This has been going on for the last decade at least,” she said.
Ulster Unionist MLA Jo-Anne Dobson said the warnings would send “ripples of fear” among the community.