Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I thank Dr. Kinsella for his helpful presentation, which I appreciate very much. I would like to ask a couple of questions before I invite members to do likewise. I would be interested to know how Dr. Kinsella deals with the various variables within the health workforce. I refer to things like the model of care. I presume all of this depends on where the services are delivered and the extent to which there is a primary and community-based focus within the health service.

Do decisions need to be taken with regard to skill mix, which has been mentioned by Dr. Kinsella, prior to the construction of a model to ensure that model is effective? A similar question could be asked about work practices. The issues of skill mix and work practices are inter-related. For example, will chronic care programmes be predominantly delivered through nurses? How many nurses does one GP equal? What is the equivalent number? Do such decisions need to be made beforehand?

How does one deal with variables in work practices, in terms of whether people are working seven over seven or nine to five or whatever, or the question of the mix between nurses and nurses' aides? Do they need to be decided before one builds an effective model?