Michael Harty (Clare, Independent) | Oireachtas source

Continuity of care is a major issue and GPs are ideally placed to provide for it. With geriatricians, they are probably the last of the generalists practising medicine in Ireland because as it has developed, it has become overspecialised. There are nephrologists, neurologists, respiratory physicians, diabeticians and endocrinologists and they all look at what is happening in their own fields. A person with several diseases will go to this or that clinic, but we are left to decipher what has happened in all clinics. Quite often we say to patients not to have a prescription filled until they see us first, as the drugs prescribed by a particular consultant may not be compatible with the others being used by them. Continuity of care and being a generalist are extremely important in general practice which we must preserve and develop.

The service in Kilkenny is an exception, but in the other hospital groups we are losing the connection between the GP and the hospital, which is so vital. I once asked an endocrinologist at a meeting why he kept bringing back all of the well controlled diabetics every six months as I did not see the point. He argued that diabetes was a lifelong condition and that the people in question could not be discharged. That is the mindset we must try to break down. As a hospital doctor, the easiest thing to do is what everybody else did in the past, with the result that the process becomes self-perpetuating. We need to get hospital consultants to look up to see what is happening, as what is happening cannot work. Deputy Billy Kelleher asked the question, but I am very interested in the answer. Where is the resistance when it is crystal clear that what is happening is not working?