Mick Barry (Cork North Central, Anti-Austerity Alliance) | Oireachtas source

I thank each and every one of the delegates for coming before us this morning. It was a very interesting presentation. I was reminded of the fact that, many years ago, when I was a secondary school student studying history, I was enormously impressed with the story of Dr. Noel Browne. I have always felt, since that time, that doctors speaking out against the problems which bear down on low income, working class communities provide a powerful voice. I would also say it is a pity there are not more doctors, in particular GPs, who speak out about the issues and problems that confront communities. It was a really interesting presentation.

My understanding of the analysis provided by the witnesses is that there is a double discrimination operating in low income, working class communities, in that there is social disadvantage - low pay, low incomes, poverty and so on - and then a disadvantage and a discrimination in the way the health service itself is set up, and that the witnesses want to concentrate on the second part of that today. In that regard, there is one issue I would like to clarify and there are two questions I would like to raise.

The point I want to clarify concerns the principle of what the witnesses described as the inverse care law. As I understand it, they are saying that if GP resources are distributed according to size of population, then, because more people are likely to present to the GP surgery in a low income, working class community, there is less of a service available for them. Am I correct that the witnesses feel that, on top of that, it is often the case that GP surgeries in those communities have to serve a greater population? Am I also correct that, if there is a situation where people are twice as likely to present and the population area is twice that of a more affluent area, the level of health care being provided by the GP, and that can only be provided by the GP in that community, is a quarter of what would be the case in the more affluent community? If that is the case, it is a stunning statistic, but I am looking for clarification that I have understood the basic idea.

How much time does someone presenting to a GP in the communities represented by the witnesses have with the GP? Obviously, there is a huge difference between having a 20 to 25 minute consultation and a ten or 12 minute consultation? I read a story recently about how GP consultations in the UK are now often less than ten minutes. What is the position in the experience of the witnesses and can they generalise as to the experience overall? Do we have that experience of people coming to a GP and having ten minutes or less? How bad is the problem?

The Deep End Ireland submission states:

There is a need for fully functioning primary care teams in disadvantaged areas... This means ending the recruitment embargo for primary care team front line workers in these areas and also matching personnel to local needs.

Will the witnesses give a little more of a flavour of what the recruitment embargo means in practical terms on a week-to-week basis?