Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank the Chairman. We have discussed this a great deal. Every element of what we are engaging on with the IMO on now is pointed towards Sláintecare. Sláintecare is the singular test in all of the asks we on the State side have in the engagement with GPs. I do not wish to negotiate in public. I would be in awful trouble if I did. When I talk about sustainability measures, I am talking about making general practice sustainable so that it can deliver Sláintecare. I am talking about ensuring there will be enough GPs who feel theirs is a challenging but rewarding career in which they wish to continue. Sustainability, which is one of the three elements of the current talks, refers exactly to what the Chairman says. It is about how we ensure enough people come into and stay in general practice. It is a key element. The other elements are access at eligibility and chronic disease management and they are directly focused on delivering Sláintecare by taking services which are currently provided in hospitals and providing them in the community through general practice.

On eligibility, we must recognise that if we do not support general practice they cannot do this, but if we do not do this we will end up in a situation whereby people continue to end up in the hospital setting far too late in the development of their illness because cost might have been a barrier within primary care. We saw the recent report on primary care, the lack of universal access here and how that compares unfavourably with other countries.

While we will not have a big-bang new contract - and I accept that assertion that the Chairman is making - we will have a framework that will deliver a number of new and exciting services, but will also invest in general practice, recognising that it needs to be sustainable. The Chairman did not say this but I hear others say that all of the money that the Government wants to invest in general practice is for new services and that is not right. As a Government, we recognise that before people are asked to take on new services, which the Chairman and I know that GPs want to take on if they are supported in doing so, we have to make sure that the current service is sustainable. I accept that after years of FEMPI cuts, we have come to a position where general practice needs support to stabilise it.

I concede that there will not be a big bang contract moment by the end of the year. However, there will be significant investment in general practice and a multi-annual framework for that investment and for the roll-out of services. That framework will help us to continue to develop, evolve and modernise the GP contract. This is a period of four years that we are discussing. I cannot go too far on this in public but we are also trying to make sure that we do not conclude these talks at Christmas and say "that is it, we are done, we have delivered a GP contract or reformed it." It should be part of an evolution and there will be more issues we want to talk about and more changes we want to bring about in the future. It is about getting a framework in place and when members of the committee see what we are trying to do, subject to us getting agreement, they will see much in it that they will like.