Dr. Denis McCauley:

I thank the Deputy. On that matter, and going back to the national cancer strategy, we on the ground level can only look at the parameters of the performance measures that are in place. I must admit that the overall governance arrangements are probably above us. From a general practice point of view, the national cancer strategy had two main aspects. One related to giving us access to more diagnostics. Quite a lot of the time, we find we are taking up space in outpatient departments because we are referring people for tests. We are actually quite good gatekeepers. We give access to tests that we can make good use of, particularly if we get feedback on them. The crisis has sometimes given us an unexpected pathway to diagnostics. For instance, during the malware attack currently ongoing, we have been given direct access to MRI scans and CT scans and more access to ultrasounds. That is probably a short-term force majeuremeasure but something like that would allow us to help in early diagnosis, taking pressure off of hospitals while ultimately increasing the health of the population. From the point of view of the national strategy, we can only look at bits we can improve on in our own sectors. That is one offshoot that has helped in that regard.

The other aspect of the strategy to consider from the general practice point of view is something like the chronic disease management model, under which GPs were to get involved in cancer aftercare. That was a good idea which has run into the sand. It is something the IMO promotes would take pressure off of the hospitals, giving them more of a chance to do acute work rather than chronic work.