Dr. Denis McCauley:

I thank Deputy Burke for his question. On the principle of care within the community without referral to the hospital, the clinical evidence is that this approach is effective and also cost-effective. When that care is properly resourced and planned it works.

Last year, the Irish Medical Organisation introduced a deal under which chronic disease will be managed more in the community. We will be able to manage some 80% of the chronic diseases in general practice to a very good standard. The resources, evidence and planning for this are available. This is a template we can use in other areas. As Dr. Clyne has said, 20% of those people will need to be referred on. The concept of care within the community is good for a certain cohort.

There is no doubt that if diagnostics were more freely available to us, we would be able to attend to a certain number of people and reassure them that everything is fine. We could also be able to identify people who need to go to hospital. There are ad hocsystems in place throughout the country where scanning has been made available to GPs. The feedback is that these are responsive, very effective and give reassurance to patients early on that everything is fine. It also gives reassurance to the doctor that the person does not need to be referred. If 100 people with abdominal pain come in, it will be possible to identify and screen out those who need to go to hospital.