Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

Speaking of romance, what more romantic date could one have than meeting downstairs in a committee room on St. Valentine's Day? We are underselling ourselves.

The statistics which have been presented by the delegates are very interesting. I note the anticipated increase in the size of the population. Are there ways to update the data on a regular basis? They are three years out of date if the base year was 2015. To what extent can they be updated to give a snapshot on a regular or annual basis?

The very sizeable projected increase in the population will depend, of course, on economic progress. Are there projections for the increase in demand under the various headings, for example, paediatrics, maternity services and home care services? We have received some information in that regard, but can the delegates update it for us?

I note the reference to public hospitals accounting for 85% of the total number of inpatient bed days and private hospitals accounting for 15%. Do the delegates have suggestions for how, in the short term, the private hospitals could assist where there are particular bottlenecks at specific times?

I am sorry about the questions which I am formulating as they come into my mind.

On the rapidly ageing population, I get a little sensitive, as one does and as the Chairman knows. With the very large expected increase in the size of the population, what age group is expected to be the most demanding? Obviously, there will be a cohort of young people. There must be a huge counterbalance in the form of the younger generation, including children and young professionals coming into the country. To what extent have the delegates incorporated it into their findings?

Traditional GP practices have changed. That is correct. I remember that in my county once upon a time we had the third or fourth generation GPs in the one hospital, the old district hospital, who took great pride in their role. They were traditional, committed to their vocation and their word was the rule. There was a huge degree of patient satisfaction and it was very seldom that things went wrong, including in maternity wings, in the old hospitals. Is there anything we should learn from it? Can we learn from the traditional GP practice where a son or a daughter entered the practice which was carried on in the particular area, leading to huge patient satisfaction and their reliance on the GPs? Has that practice ceased? Has the chain or link been broken and, if so, to what extent?

A question comes to mind about the new services coming onstream. My colleague referred to the under-sixes scheme, which does place a demand on services. What has the benefit been? Has there been a diagnosis of issues in particular areas that would not have come to the attention of the practices otherwise? Of what consequent benefit has it been in streamlining services?

The Chairman will be glad to know that I will come to an abrupt halt in a minute.

There was a question about the out-of-hours service. It is a good service, but there have been some issues with it such as the lack of continuity, the lack of knowledge of the patient and so on. Sometimes that can be good as a new or second opinion can pick up on something that was not noticed previously. Do the delegates have any comment to make in that regard?

I do not think the running of a business should be part and parcel of the burden of running a medical practice. A way or means has to be found to deal with that issue. Running a business can be a stressful activity. As we all know, it can divert attention to a huge extent, particularly during an economic downturn, which can sap the energy of all those involved to an extent that outweighs the benefit of having this model of the GP being the employer, etc. There are far too many more urgent issues to which they should be able to attend. I know that GPs have mixed views on this issue, but it looks to me as though some element of a salaried system will have to be introduced, for some GPs or a period of time, initially at least. It is hugely beneficial for practices to have people with experience who built a practice over a number of years. That means building a business also, but that is neither here nor there. The point is that they have dedicated themselves to it. There are surgeries at 8 a.m., 2 p.m. and 6 p.m. and they also make house calls. That did not come easy and it entailed a huge commitment, with time being taken out of their lives. How do we reward that commitment? What model do the delegates have in mind to possibly recognise the input and contribution made and the loss of time incurred in family life and so on? We want to provide the best possible service for the general public which, as we all know, can be demanding, but we live in competitive and demanding times and it now expects the highest possible quality of service.

Back in the old days, pharmacists had a different role. They were effectively GPs and regarded as such. Over time that has changed and they are now dispensing drugs on prescription and so on. Is there a need for a re-evaluation of their role to give them an opportunity to participate more actively in the delivery of services to the community?