Dr. Brendan O'Shea:

On behalf of the Irish College of General Practitioners, we are very obliged for the opportunity to come and present to the committee on chronic disease management. We recognise the absolute importance of collectively delivering good chronic disease management in our surgeries and in the communities of this country. There is pressing work to be done on the issue. We are making a joint presentation by way of opening comments.

At the Irish College of General Practitioners, we support the development of a five to ten-year plan to address the challenges facing our health care service. We are here today to outline cost-effective solutions aligning care nearer to patients in the community and delivering safer, better and more efficient chronic disease care. The more the patient is taken out of the community, the worse the care is and the more expensive it becomes. Patients want to be cared for in their communities. Some of our solutions, as addressed in our main submission, can be implemented today. There are things we can do immediately through effective legislation and it must be remembered that the committee's members are legislators.

Other recommendations may take longer to implement, but we congratulate the Oireachtas on providing for a ten-year timeframe and depoliticising the issue. We wish members the very best in their work in this committee. There is an urgent and critical need to agree to a new contract for general practice to effectively support the care of the complex patient in the community. GPs and general practice are central to this process.

I am director of the postgraduate resource centre in the Irish College of General Practitioners, ICGP, as well as a family doctor in Newbridge, County Kildare. My locum had to leave and I spent the whole summer trying to find cover for my partner who is on maternity leave. This morning my patients are being looked after by Dr. Eamonn Dillon and Dr. Noel Caffery. It was a horrible summer. Dr. Brian Osborne is assistant director of the postgraduate resource centre and a GP in County Galway. Dr. Laura Noonan is the director for new and establishing GPs at the Irish College of General Practitioners and responsible for GPs who have graduated in the past five years. She set up her own practice seven weeks ago. Dr Mark Murphy, ICGP chair of communications, is a GP in County Dublin.

In the ICGP's opening statement we will briefly provide context by outlining a typical day in the life of a GP. We will discuss the challenges facing patients with complex comorbidities, a particularly vulnerable group. We will highlight current concerns, but we have brought solutions, if members will listen and legislate. If they do not legislate, they will fail us all. We will discuss the core challenges facing patients with chronic diseases in our struggling and very difficult secondary care system and outline solutions.

There is a need for a new contract for general practice as a matter of urgency and we should relax a little about it. In all the agencies which negotiate contracts for general practice there is a feeling that it is such a difficult and awful job that once we have done it, we will have to leave it there for 20 or 30 years. That process has failed patients; therefore, we call for a new contract as a matter of urgency and for it to be subject to continuous review every 18 or 24 months, no matter how difficult it is to do. If we do not get together to discuss the difficulties, poor patients will suffer disease and die younger. It is as simple as that.