Dr. Brendan O'Shea:

We would point the committee in a particular direction. There are various models that have been elaborated. The World Health Organization elaborates the chronic care model. In the United States, in the early 2000s, they suddenly realised that they were spending more on health care, through a specialist delivered hospital based insured fee-per-item chronic disease management system, than on weapons. Obamacare is the switch-on of community-based primary care. There is the Patient-Centered Primary Care Collaborative, which is an umbrella group that has quickly gathered a considerable volume of information from a variety of different sub-systems in the United States, and there is clear objective evidence that it is effective and there are clear guidelines in terms of how it works. If we go back to our strategy, for example, at present there are 4,000 GPs and approximately 1,900 practice nurses, many of whom are part time. In effective systems, it is at least a one-to-one ratio. In the college, we would believe that we probably need closer to 5,000 GPs and 5,000 practice nurses.