Dr. John O'Brien:

We are open to all solutions but we need to see there is a problem. There is also the case that when people have worked very hard in the system for very many years, at 65 years of age they want to go. That needs to be taken on board. Even though they can stay until the age of 72 years, a proportion of them are unlikely to want to stay until they are 72 years.

On the issues of suicide and an emergency room, the UK had a national confidential suicide inquiry and the upshot was that the intervention of a 24 hour crisis team was the single intervention to have the most impact on suicide rates. We need to be focusing on how we do things as much as anything else. If we are to have such crisis intervention teams, they need to be specialist delivered or closely led. They cannot be, as Dr. O'Shea said, a junior hospital doctor being called an expert. That is not true. That is one side.

The other issue is the impact of social media. I agree that it is a significant problem. I do not know how any society is getting to grips with it at present but I think it is a major problem and it boils down to bullying and a range of other things that are very bad. We will see a greater increase in the level of childhood mental health problems coming forward. It will come to us in the first instance.

We have an ambivalent attitude to the abuse of alcohol. We are amused and horrified by it in equal measure. There are two aspects, one of which is that GPs and all health care professionals need to be banging that drum on an ongoing basis, but I also think we need a wider discourse as a community as to how we might address it as this is peer driven. When a person's friends are drinking heavily, so is that person. That is the way of it. Young people in particular engage in binge drinking. It has an impact on mental health, liver disease and I could go on and on. Very valid points were raised.

On the issue of ethnicities and how GP practices are coping with different social norms, I think GPs are dealing with it. I do not know that we have an overarching overall policy. There are different aspects, and some will fall into women's health education which is quite extensive in the college. As I said earlier, a GP takes all comers and takes all problems and addresses them accordingly. GPs have a continuing medical education programme and would have an awareness of the various and variety of problems that people in the community are experiencing.