Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I thank the witnesses for their attendance here this morning and their presentation. There is a great deal of talk about primary care and the need to shift in that direction. We heard evidence from colleagues of the witnesses that it is possible to manage 95% of chronic conditions in the community with the requisite supports and resources in place. That would reduce the reliance on the acute hospital sector. What would the witnesses' vision of a fully staffed functioning primary care service look like?

What would the employment relationship be between an independent contractor and all of the other staff that are necessary? I understand that as an independent contractor, a GP would employ a practice nurse. It is easy with a salaried GP because everybody works for the same employer but in a fully staffed proper primary care centre, how do the witnesses envisage the relationship between the Health Service Executive and the primary care centre? How would it work with an independent contractor?

My second question is on skill mix. For my sins, long before I was here, I was a member of the European working time directive implementation group. We talked at length about skill mix. Every single group in the room said they wanted to do more and they wanted do things differently. There is clearly a blockage because that committee sat and met for a long time and we could not get over the skill mix issue. I am interested in the witnesses' views about where that blockage is, because there clearly is one, and how we might get around it and better manage and utilise the skills we have in the health service at the moment.