Dr. John Delap:

We have outlined many of the challenges facing general practitioners working in areas of socioeconomic deprivation. I wish to highlight that there are also great opportunities to improve outcomes throughout the health system. We have some suggestions based on the experience of GPs in Deep End Ireland, as well as those in countries such as Scotland. There is an overarching need to target resources where needs are greatest - we want to emphasise that point today. Within this context we want to highlight four main areas. First, there is a need for fully-functioning primary care teams in disadvantaged areas in particular, where team-working is such a key part of delivering effective care. This means ending the recruitment embargo for primary care team front-line workers in these areas and matching personnel to local needs. Second, we need strong primary care infrastructure in deprived areas to act as local hubs around which local services should develop. This is related to our third priority area, which is the provision of support to general practitioners and practices in these areas. GPs need more consultation time to address the complex needs that we have described. The flat distribution of resources, a feature of the inverse care law, means that the only way GPs can currently deal with the increased demand in deprived areas is to have shorter consultations. This results in missed opportunities for prevention, cancer screening and chronic disease management. A change could be facilitated through a deprivation weighted capitation payment in a new GP contract or through other options, such as providing salaried GPs to practices and additional practice staff or additional funding for practice nurses and administrative staff. The fourth priority area relates to the extraordinary pressure resulting from the lack of access to diagnostics and other speciality care supports. While this may be a national problem, it is substantially worse in areas where there are greater health needs and where people do not have the option of the resources of private health schemes.

I thank members very much for taking the time to listen to our views and suggestions. We are happy to clarify any issues they wish to raise and to answer any questions.