Dr. Liam Glynn:

A version of general practice which I do not recognise is being created by the committee. I am a rural GP and will return to work a Shannondoc shift tonight. I will cover west Clare, from the Shannon Estuary to Galway Bay. Deputy Alan Kelly correctly identified the changes that had occurred in Shannondoc, which I completely agree have been extremely regrettable. The only area about which I can speak is west Clare where five years ago there were 20 doctors working, but now there are 15. We have lost 25% of our workforce. Therefore, it is not possible to provide the cover we once provided. It would be fantastic if we could. To me, this is the perfect symptom of what is going wrong, which is that we cannot get GPs to work in rural areas and urban deprived areas.

Examples have been given of practices which have no applicants. I know of a practice which advertised a vacancy in Naas, a commuter town which one would perceive to be well off, but no one applied. This is happening across the board. I am particularly aware of the problem in rural areas where there are real challenges. There are increased poverty and deprivation levels. There are also increased age levels which are associated with the multi-morbidity described. We go to work every day to try to keep our patients away from hospitals. I echo the statistics mentioned. We simply cannot get people to fill posts. It reflects what young GP trainees think about their future being in this country. We need the contract badly because there is a complete lack of certainty about career progression. If we could provide the contract, perhaps we might provide certainty and be able to bring back the cohort who are already abroad.

People spoke about locums running practices, but we cannot find locums and even if we could, we would not be able to afford them. There is huge variability in the general practice model throughout the country such that we need to take the differences into account.