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

I am sorry for coming in and out. I hope I will not repeat some of the questions asked before. If I do, let me know. Productivity of the workforce was mentioned, as was primary care service being GP-heavy. The consultants referred to single GPs operating on their own. When it comes to the geographical situation in Ireland, this is an issue because we have remote parts with low population. There is need for single GPs to service these communities. Although I am all for the primary care centre, it simply will not work in certain parts of Ireland. The consultants spoke to their experience rather than the report. Has that been considered?

Attracting GPs to primary care centres seems to be an issue in Ireland. We appear to have some good centres set up but getting GPs to come and work in what is a semi-corporate set-up is difficult. It was always the case that it was integral to a GP's work that she was in charge of her practice and was almost a doctor and a business person in the same way as a pharmacist. I am a pharmacist by profession. Is that where PA Consulting Group believes the barrier is? Is it a question of losing that autonomy? Do the consultants have any views on that?

The consultants spoke about how in other countries nurses are upskilled to do certain jobs and GPs become more specialist. Do the consultants have any view on the barriers to GPs letting go of certain bread-and-butter practices, for want of a better phrase, that are crucial to keeping a certain baseline revenue coming in to a practice? I have in mind things like repeat prescriptions for contraceptives. I firmly believe these can be done in the community pharmacy setting through the Oregon algorithm to make it safe to deal with contraceptive needs of women and men.

The consultants spoke about the current stock value. Will they elaborate a little on the beds we have? They spoke about isolation rooms. Will they elaborate on that? Is it the case that the stock we have is not primary stock? We may have large numbers of eight-bed wards. I take it from what the consultants have said that such a set-up might be counter-intuitive because if there is an eight-bed ward and disease is spreading, then it will compound the issue and we will have more admissions.

Senator Burke referred to the New Zealand model whereby the GPs go into the hospital. I was at a hospital in Kilkenny looking at the system in operation there. To my mind, the system operating there is the way forward. It is not the solution but it is a partial solution. It seems bizarre that a GP, who is the anchor to a patient's healthcare, would refer a patient to a hospital and then the patient goes into the same room as another who has broken his leg on the football pitch, even though the first patient has essentially already been triaged by the GP.

I imagine the consultants know that in Carlow and Kilkenny a community pharmacist is involved in the discharge process.

The service is more seamless and there are fewer errors. Have the PA Consulting Group considered that? In reply to a member, I think it was Deputy Donnelly, it was stated that a consultant leaving somebody in an acute bed for a day longer has repercussions for those on a trolley somewhere. Perhaps I took up that point incorrectly.