Dr. Edel McGinnity:

I will respond to the question from Deputy Brassil on the balance between social and medical backgrounds. I described a case in which diabetes is a serious health problem. The management and control of my patient's diabetes is caught up in her social situation so it is impossible to separate the two. There are many things one can do. One of the biggest contributors to ill health is smoking. A women's no smoking group has been set up in the area that I work in by the Irish Cancer Society, the HSE, the primary care team and ourselves, and we are closely linked.

One of the key things about general practice, and why we would like to see it placed at the centre of care in these areas, is that patients trust their GPs. They will trust us when we refer them to a service or counsellor. Patients are often slow to access services off their own bat but they will avail of services if we recommend them and tell them that another patient has had a successful outcome. A women's no smoking group is a primary care initiative that has worked well. It provides good social support to the women over six weeks. Many of the participants have stopped smoking and they have all benefited. Their health will hugely improve. A couple of these groups have been started and quite a few of my patients have stopped smoking plus their health has improved enormously. Social and medical backgrounds are intimately connected and general practice is at its fulcrum because we deal with everything, and are accessible every day.