Dr. Brendan O'Shea:

They are leaving for two reasons. One is professional repugnance at the way that patients with chronic diseases are managed and what they can do for them. There is also the socioeconomic pull of salaries in other health systems that are more remunerative. We need to recognise that.

With respect to premises, when politicians are designing the new contract, it should have some degree of complexity. One size will not fit all. We know there are pressing areas of concern in rural practices and practices in inner city areas. They will probably need different solutions than mainstream general practice, if such can be said to exist. The Government should try not to do one size fits all. Most important, it should be set up in order that real-time evidence is coming back and the Government is not three years behind on the data. The contract should be reviewed after 18 or 24 months. In that case it will be progressed within the committee's five to ten year timeframe. It is not rocket science. It has been done in other systems and can be done here.