Dr. Emmet Kerin:

I will address the question from Senator Colm Burke on local integrative care committees. The arrangement in Carlow-Kilkenny is the shining example and it is often referenced. That was a long process. I have been there and I have examined the model. I have tried to get something similar established in Limerick. One theme that came out related to trust and relationships. The building of trust and relationships has to be organic. This is difficult when people are under pressure and are facing cuts. It is also difficult for GPs operating in marginalised areas that are no longer feasible. There is a level of hurt and mistrust between the departments and the HSE. We need to build that up. It happens slowly over time. I will summarise a theme that came out today on the contract side. It relates to what Deputy Kelly has said about the joint committee writing to the Minister to make this happen. The message for the Irish Medical Organisation is that there is a need to work at the same level and that building the contract together is better.