John Dolan (Independent) | Oireachtas source

I thank the Chairman for that accommodation. I apologise for not being present at the start of the presentation. I wish to focus on sustainability and development. My interest in the area comes about from my involvement in the disability movement. I have a personal interest in several chronic conditions and know that ground quite well. Professor O'Dowd mentioned that many of the pieces of the puzzle are there but there is frustration that they are not joined up. What could be done to help to join up those pieces? Primary and secondary care and hospitals and so on have been mentioned but I am conscious of and very familiar with the work done by many support organisations or patient groups, those being organisations set up to support those with particular conditions such as post-polio syndrome, muscular dystrophy, multiple sclerosis, motor neurone disease and epilepsy. Could there be a better role for those groups, which are close to people and families and some of which are involved with clinicians in certain areas? Could they be part of joining up some of the pieces?

Professor O'Dowd mentioned that 8.5 GP visits per year is optimal in terms of best supporting people. Could the service sustain 8.5 visits per year or would it crack open? In several respects, it is very clear that the current system is vulnerable and not very healthy in terms of sustainability.

Professor O'Dowd mentioned private health insurers not in the primary area. Towards the end of his presentation he discussed a shift from the institutional model of care and said that a bias exists which is pushing things away from the primary area.

It registers very strongly with me that he stated that, at the hospital level, behaviours are set and diseases are at an advanced stage, which is obvious. He stated that many health professionals want to be in front of and support people earlier on. There is no doubt that developments in recent decades have meant that many permanent, chronic and long-term conditions can be diagnosed far earlier, and thus earlier intervention is possible. There may be other views on that point. Thirty years ago there was not the same awareness of patients' conditions. There is now a greater opportunity for early intervention than was previously the case. If I am not present for the replies to my queries, I will check the record in that regard.