Dr. Madeleine Ní Dhálaigh:

I thank the Deputy for his question. A good way to look at this is to compare the urban and rural situation. The Deputy referred to a large area in his constituency where there is no GP. In the same way that IDA Ireland supports business, we need to consider something similar for our young or emerging GP colleagues. If two GPs want to set up, as Dr. Crowley has just said, the financial barriers are enormous. They are at a very difficult stage in their lives, with young families, their own personal mortgages and their own personal debt from college fees. In that context, we need to look at supporting GPs in much the same way that IDA Ireland supports our business colleagues. That could include providing tax relief and help with the cost of premises and equipment and with set up fees. Our GPs are highly trained and highly qualified and what the State will receive in return will be a multiple of what it invests.

Regarding our rural colleagues, what we are seeing now, and this is no longer confined to just the western seaboard, is significant difficulties in getting emerging GPs to take up lists because of remoteness and poor out-of-hours cover. Furthermore, small lists with very little other income apart from the GMS list, means that many practices are not financially viable. That has to be looked at as well because it is not just an issue along the western seaboard but right throughout the midlands as well. I know of a practice close to Kilkenny city that has been finding it extremely difficult to find a GP, as Dr. Crowley can attest. We have to tackle this.

Universal healthcare through Sláintecare is a great aspiration that I very much support but emerging GPs do not want to be left on their own, where they have to create waiting lists, they are isolated, they have financial burdens and are referring into a void because there is no secondary care for their very unwell patients. Let us say a young woman or young man attends a GP with a cruciate injury sustained in a weekend sport. The GP will try to arrange secondary care but that patient will not even be seen for two years, not to mind getting treatment. All of these factors are making GPs very reluctant to set out on their own without supports. We have to support them.