Dr. Brendan O'Shea:

Apologies for getting agitated. I shall breathe deeply. It is really important to be clear that the only part of the Irish health system that is uniformly electronically enabled is general practice. In all of the acute hospitals, they are scribbling on paper records, bar the maternity hospital in Cork. Notwithstanding the billions which have been spent in the acute hospitals system, they are not computerised. The other parts of the primary care team which are not GP led are not electronically enabled. We engage with our colleagues in the Office of the Chief Information Officer and understand that they will all have email in the early part of the new year, but it will then be 2018. It is really important to be clear about that. The only part of the health system from which the members as legislators can get reliable big data is from my colleagues and I and our practice nurses. That is the first point.

The second point, which I am delighted to make, is that Senator Feighan is right that we need to be positive about the things that are working. The members are getting good health care because we are the affluent. Julian Tudor Hart is a Welsh general practitioner who stated that the people most in need of a service were least likely to get it. In a corollary to his law, he said this impact is most likely to occur in societies where there are untrammelled commercial interests at work. That is Ireland. That is the image of private, for-profit health care and private clinics. The people we feel most agitated and anxious about are the deprived people attending our surgeries. With respect to the wish to have a medical card, the position of the Irish College of General Practitioners is that we regard easy access to primary care and general practice as a really important social benefit. We are in favour of extending free-at-point-of-delivery primary care in principle, but it must happen on a phased basis and in a way that does not break our services. Our services are at breaking point.

What are the good things we have done? In the Irish College of General Practitioners, we are collaborating as closely as we can with everybody, including the HSE, the Department of Health and the Minister and it is difficult. Senator Murnane O'Connor asked about the contract and our engagement with the Minister. There have been a lot of promises and there is an absolute wagon-load of policy but getting the deals done is incredibly slow and people are dying because of it. To go back to the positives, we understand within the college that large numbers of our very young and bright medical undergraduates are interested in going into general practice. We have had an increase of 58% in the number of young doctors applying for our national GP training scheme and have increased the number of places to over 200 this year. In Ulster, however, they have 110 places for a population of 1.1 million, which they think is not enough. I hope I have touched on some of the questions.