Kate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

It is not mine.

While I understand the rationale behind the proposal to have a community pharmacist in a GP practice, a practice in which there are four GPs would cater for approximately 8,000 people and for a community pharmacist employed for one day a week to trawl through the medication histories of those patients would not be practical. It is not a solution. A more appropriate solution would be a collaboration between the GP practice and the community pharmacist in the community setting. If, as a pharmacist, I am employed by a GP to scrutinise his or her prescribing and he or she is a bad prescriber but is paying my salary I might not be open to telling him or her that I do not agree with his or her prescribing or that it is not in line with the National Institute for Health and Care Excellence, NICE, guidelines. There would be an automatic conflict there. In my experience patients have different relationships with their pharmacists to those they have with their GPs. Often the information that pharmacists get versus what GPs get is different, so when pharmacists have conversations with GPs we improve outcomes for patients. I would be concerned about that proposal and about the proposed new role of clinical pharmacist and what that means. We do not have clinical GPs. Rather, we have GPs who are on the specialist register and trained to a high level.

I welcome the statistics which show that when patients have a regular GP and they see him or her eight times per year it leads to a reduction in hospital admissions, which is something that anyone who works in the community knows without having to look at the statistics. We know that when people have a go-to gatekeeper they have better outcomes.

Access to diagnostics was considered in the context of the Sláintecare report. I am concerned that we have not seen any move in this regard. One of the main concerns of GPs was getting access to diagnostics for patients. I may have missed reference to this in the ESRI report. The Sláintecare report recommended stand-alone diagnostic units for GP referrals. Do the witnesses agree with that concept and, if not, what in their view is the solution, bearing in mind that we cannot have MRI machines in every GP practice?

It was mentioned that cost in terms of visiting a GP is a deterrent to one in three private patients. In the Sláintecare report, any barrier to access was seen as a negative. Are the witnesses saying that we should be looking at universal free access to a GP and, if not, what would they suggest to mitigate the cost deterrent? People who need to see a doctor but cannot do so owing to cost usually end up in a far more serious situation in our acute hospital setting. I have to leave the meeting at 10.30 a.m. as I have another appointment. If the witnesses do not get an opportunity to answer my questions before I leave, I will follow up on them when the transcript of the meeting is available.