Dr. Ray Walley:

In dealing with the HSE and the Department of Health mental health is not an agenda item on the contract because the same deficiencies and difficulties are the case in general practice, which is the first port of call. That is the case be they within child and adolescent mental health or physical health where we have a staff deficiency, an aging staff and a recruitment and retention problem. That is rumbling away like Mount Vesuvius but it will explode. There are 666 general practitioners, GPs, over 60 years of age. Where I work, in the north inner city, if there is a child or adolescent with mental health problems there are usually lots of co-morbidities in that family. We are dealing with many different issues. There is no evidence of funding in the contract talks. Whatever happens as a result will have to be phased in because of the potential workload of co-morbidities that we are not addressing, the aging GP population and the recruitment and retention problem in general practice. Everything that has been said about psychiatry applies to general practice. There was a withdrawal of 40% of funding for general practice through the financial emergency measures in the public interest, FEMPI, cuts when most businesses run at a 30% turnover. That was a 40% cut before costs were taken into account and our costs are stable.