Dr. Brendan O'Shea:

If the committee assists in building capacity in general practice in the years ahead it will have done great work. We wish to reflect on building capacity in the general practice team. The primary care team was referred to from 2001. A lot of time and effort has gone into it. Arguably, the outcome from that has been somewhat disappointing. Our interest is in building capacity in general practice teams. Capacity in general practice is not just about GPs. We want to build capacity so that we have GP-led primary care management of chronic disease in the community. That will require an increase in all general practice staff. GPs have the capacity to delegate work within their practices but the people to whom they delegate their work must also be appropriately trained and funded. The concept is in keeping with the principle of enabling GPs to work to the higher end of their skill sets and contracts, leading to even more productive teams under the independent contractor model.

In the briefing document, we elaborate more on the following topics, including how to recruit and train more practice nurses. In the ICGP we collaborate with our practice nurse colleagues in that regard. We are also examining how to increase the number and capacity of practice managers and administrative staff, how we can interact and how the primary care team can be more effective as well as the extension of information technology, which in the Irish health system is really only located in general practice and must be disseminated into all other parts of the health system. In colleges and university departments of general practice we can deliver ongoing research and educational support to effect those changes. We are coming to the committee this morning with solutions and the members must put energy into those solutions, if they can do that.