Alex White (Dublin South, Labour) | Oireachtas source

I have. I will mention that when I come to the conclusion of my remarks. In the course of the engagement that we have to have on the draft contract, this particular clause, which has been described as a gagging clause, is one that we will clearly have to address. I think we may well be persuaded that it should be reworded. Conceivably, we may well be persuaded that it should be removed. However, we cannot have a discussion with ourselves on this, and I now come to the Chairman's point.

We cannot negotiate with ourselves. We cannot say all of these things are on the table but, as I said yesterday, there is nobody sitting at the table. On three occasions, I have invited the representative bodies of the general practitioners to meet me in regard to the draft contract. I did so on 31 January, when I met them in person, by letter on 27 February, if my memory serves me correctly, and again last week on 26 March. I want to have the real and meaningful engagement the IMO, for example, has said correctly is necessary on this, the so-called gagging clause and a number of other issues it has raised with me. In fairness to the IMO, it has made a submission in regard to the draft contract which would be the basis for our addressing the issues about which it has concerns. However, it would be much better if we discussed it across the table. I again invite the representative bodies to meet me.

I repeat that if there is any question in anybody's mind that it is my intention, or that of the HSE, the Minister, or the Government to gag general practitioners or to, in some way, prevent people from advocating, for example, on behalf of their patients or from exercising their independent professional judgment, they are wrong in that impression. That is not our intention and we can deal with in negotiation when we get to the table and address it as with all the other issues in the draft contract. I keep describing it as a draft contract.

I can understand the media to some extent. The desire for the rhetoric of back and forth is always understandable, and I do not criticise that; we are in the political world and words come and go. The fact is, however, that when we put out a draft contract in January, that was our proposal in terms of the direction we see the thing travelling. It was not the last word and was never intended to be the last word. Sometimes when I meet general practitioners, I have to explain to them that this is our initial offering for debate, discussion, engagement and negotiation. I repeat that we must resolve this together, in terms of having a contract in place that is in the best interests of patients, citizens, the HSE, the health system and doctors themselves.

On the bureaucracy question, I understand the point that was made in that respect. I have been in GP surgeries and people have pointed out to me the amount of paperwork, e-mails and general administrative work that doctors are being asked to address. Data on population health is a hugely important element of what we need to do in the future in primary care. We need good data. The unique patient identifier legislation is going through the Oireachtas at the moment and in order to manage the health of the population in primary care, we need good data. In that context, we seek the co-operation - and make no apologies for it - of general practitioners and other professionals. This is also about the configuration of resources in primary care. The doctor does not have to be the person who does all the administrative work. Doctors argue that they need resources, and of course there is an issue with resources, but we do not want doctors sitting at a computer all day long. We want the doctor doing the work that the doctor is trained to do. It is an issue of how resources are configured within general practice. I can see that myself when I visit people and I can understand the issue. However, there will be an element of administrative return in general practice no matter what model we adopt. Anyone who looks at international best practice in primary care will see that data collection and return is an enormous part of that. Once we get the proper IT systems in place, it will get easier as we go along. The hard part is at the start but once the systems are in place, it will be possible for it to work in a smooth way in the future. Consultation, engagement and negotiation is what we need to do with regard to the draft contract.