Dr. Emmet Kerin:

One of the reasons was, perhaps, a lack of a senior decision maker. I am not as a GP making myself distinct from other colleagues in primary care but somebody has to take the lead. I see the GP, who knows the patient and the effect of decisions made at meetings on patients, as being that decision-maker. Also, there is replication of tasks, lots of note taking by hand with no IT support and so on. The point made by Dr. O'Shea regarding the private versus the public service in terms of physiotherapy is well made.

In terms of solutions, the National Association of General Practitioners has examined the issue of primary care resource centres, which is a move away from primary care centres. A primary care resource centre would be a service similar to the primary care centre but it would comprise the type of services required in individual areas. For example, services such as outpatient infusions for chemotherapy, removing blood for hemochromatosis, diagnostics, imaging and so on would be provided by the primary care resource centre but there would be no GPs in the centres. Instead, GPs would be linked to and have full equitable access to their services.