Ms Susan Clyne:

I support what Professor Irvine said. It is important to know that the Minister has committed several times, both in opposition and as Minister, to fixing the 30% pay cut. The public health contract that has yet to be negotiated by either the IMO or the IHCA will not solve this issue. In fact, it will drive more people away. It must be remembered that there is currently a public-only contract on offer, and there has been since 2008, yet we have been unable to attract consultants on that contract. The vast majority of consultants who have been contracted since 2008 have been on a type B contract.

If all private practice goes out of public hospitals, the public hospital system will be down by between €500 million and €600 million per year. The Department and policy makers must work with us, not against us, in trying to solve this problem. However, the 30% must be fixed. As in the point made by Ms Ní Sheaghdha, recruiting doctors is a long-term process. It can take from 20 months to two years to get a consultant into post. We have identified the problems, and there are ways to fix them. We have to start fixing them now.

With regard to GPs, there is a problem in general practice. That has been highlighted for a number of years. It is easy to predict how many GPs are going to retire and how many GPs we need to train. If we fix those two issues, the gap is how we help younger GPs to establish. Establishing a practice is not like walking into a State facility, where all one's costs are paid. It is a business, and it is very costly. There has been little predictability in GP income over the last number of years. That is changing with the IMO agreement with the State, but there is little predictability about being able to say for sure what one's financial position will be given that the State controls a percentage of one's income without making any payment towards a percentage of one's costs.