Dr. Brendan O'Shea:

Over 4,000 of our practitioners identified general practice as the discipline for the purposes of professional competence. Most are members of ICGP. We have over 600 GP trainees. We have consulted widely among ourselves and allied stakeholders. This committee has a very difficult brief because health is a very complex issue, fraught with risk and cost. For ease, we have identified action points at the end of our document regarding the expansion of primary care. We feel that these are the pressing issues. There is a list of them at the end of our opening statement.

Cuts to general practice resulting from FEMPI measures should be reversed. There should be an effective contract for general practice, delivering adequate flexibility, resources and development. Adequate numbers of generalist practice staff must be recruited and trained, with planning for a population of 5 million. That has to be set in train now and we are doing our part in the ICGP to make that possible. Adequate and accountable capacity in allied health disciplines in communities should also be made available. That means electronic data that is available to drive and guide development. There should be active, ongoing, effective collaboration between the ICGP, the GP representative organisations and the HSE. Private health insurers should engage with GP stakeholders and State agencies on the challenge of multi-morbidity. Private health insurance largely does not recognise primary care management of chronic disease.

Protected transformation funds for education and research relevant to general practice development are needed. GP involvement in nursing home care and end-of-life care requires targeted funding. There should also be targeted funding for GP diagnostics in radiology and for specific clinical workloads. Expansion of GP training capacity is required, as is the development of practice nurse education to include continuing medical education for practice nurses as a priority. The use of electronic medical records and administration should be extended beyond general practice, where it is already strong, throughout the remainder of the health system, particularly hospital based services. It is incredible that most of the rest of the health care system is operating on paper. The members of the primary care team run by the HSE have no contact email addresses. That is inexplicable.

Overall, key policies relevant to expansion of primary care as a national strategic priority must be implemented urgently and aggressively as a national strategic priority, in the interest of equity, clinical safety and improving medical care. We have previously submitted evidence-based documents to this committee and to the Committee on the Future of Healthcare. We refer members to those documents. I thank the committee very much for seeking our views.