Professor Garry Courtney:

Yes. I believe GPs are able for it and want to do it. Why should they not order tests and get tests for the patient? It gives them a greater esteem and respect. They are senior decision makers. When they say they want the patient seen in the emergency department, it happens immediately. We do that. It is the way hospitals work together. I run a liver unit. Not many hospitals outside of the massive Dublin hospitals run liver units, but because I do that and take a great deal of work away from Dublin, when I want Dublin to see a very sick liver patient, it sees them immediately. There is a respect.

It will not roll out unless there is funding behind it. That is why I believe legislation is incredibly important. Deputies are the representatives of the people. They absolutely should not abrogate health. I like the idea of not having a situation where health keeps changing when a new Minister takes office. I love the idea of having an all-party consensus. Ultimately, the people who stand for election are the Deputies and they must say that they agree on the direction of health and that they agree it is in GP-led primary care. What is in it for the hospitals? Hospitals will do acute care, which is highly complex work and gives us great satisfaction, and GPs will do the chronic care, which they should be paid for and from which they should get satisfaction. However, I do not believe it will happen very quickly - I wish it would - unless there is legislation behind it.

How I see it is that we would run a service level agreement, SLA, for the voluntary hospitals. The HSE will say that it must get the diabetic waiting list down to two weeks or whatever. That is how it does it at present. That is good. However, it should also say, "By the way, you must have a GP-hospital local integrated care committee functioning. We want to see the agenda, the minutes and the action points." The chair of that committee in our hospital is Dr. Fawsitt and if one asked him to see those, he can produce them all. There is a great deal of codology and pretend stuff, so one should write an SLA which states that there must be X number of scopes, Y number of gall bladder operations and whatever, and there must also be a local integrated committee. One can legislate for that.