Dr. Tadhg Crowley:

I thank the Deputy for the question. In terms of how we help GPs, it is the GPs on the way in, the GPs who are already there and the GPs who are on the way out. If I take the GPs who are already there, because that is the focus of the Deputy’s question, at the moment we get allowances for certain staff members, such as a nurse or a secretary, but it is very defined as to what we can do. For a practice such as a group practice or a single-handed practice, it would be better if the practice was allowed to take the pot of the allowance and decide what is required for its particular area. This would mean not only healthcare assistants but also an allied health professional, such as a psychologist or a counsellor, could come in to add to the pot of treatment that a GP or a group of GPs can provide in the area. That would be very important.

In areas where GPs are single-handed, we must remember that GPs do not go into general practice because of business; they go into general practice to treat patients. In my case, I arrived to find that I was running a business and no one had ever explained what this was about as I thought I would just be treating patients. Some people are very good at business; they were not trained that way but they were born that way. If there was an allowance between four or five practices, GPs could have a practice manager who would allow them to look after the general practice side and allow the manager to look after the management side. That might make it easier for the GPs who are already there.

In terms of GPs who are coming into the system, as we mentioned earlier, it is financially crippling for a GP to come in who does not have an established practice to join. It is about trying to help them establish, first, with the various grants we alluded to earlier, but also with a hub and spoke model that allows for single-handed practitioners. To be single-handed is very difficult in this day and age. The GP is an employer and a doctor and has legal responsibilities, and there is a lot of stress. In an environment where we are looking at work-life balance, the GP is going in the opposite direction when we are trying to encourage people, first, to go into general practice and, second, to establish themselves.