Dr. Pádraig McGarry:

I will deal with that issue because it might also address Deputy Donnelly's question. One of the absolutely necessary things mentioned is the advent of chronic disease management being brought into general practice. That is a more appropriate location and that is where one of the major roles for practice nurses will be, given the present set-up in those general practices. Many things can happen and it should never be carved in stone that someone does the same thing ad infinitum. If it is possible for some people to do different things, then so be it. It may be that an administrative assistant could be trained up to do various things such as phlebotomies, ECGs, etc. That would allow the practice nurse greater availability. I am not adverse to that idea at all. Provision has been made for more practice nurses in the context of chronic disease management. It has yet to be decided how that will be implemented. The intention exists, however, and it should be expanded. For the first time, the plan for chronic disease management sets in place the requirement that any additional work needs to be resourced. That has to be expanded upon. The other thing that needs to be done for general practice is the addressing of the inequity of the out-of-hours arrangements around the country. That needs to be addressed urgently. The Department commissioned its own report on this matter about two years ago, but it has never been released and nothing has happened. This issue presents a major barrier to people going into practices, especially in rural areas.