Mr. Tony O'Brien:

Both premises and skill mix come into it. Recognising what is currently a scarce commodity of experienced general practitioners, we need to look at how we can support general practitioners with other allied health professions in order to ensure that they can design processes which work optimally for the populations they are trying to serve. That will require the extraction of resources from the acute sector over time. It will require over time some reconfiguration of the acute sector so that some facilities that we currently regard as acute facilities effectively become primary care facilities. That will be difficult. Local communities may not necessarily be delighted with that.

In regard to the issue of agencies, the only reason the health service depends on agency staff currently is because of its inability to fill permanent posts. No health service manager, apart from in rare exceptional circumstances, wants to have a dependency on agency staff, either in medical or nursing. The Deputy will be aware that currently there is a real challenge in recruiting permanent staff notwithstanding our willingness to give permanent contracts. It is a major difficulty for us. Every conversion improves sustainability and quality and also improves the financial bottom line.