Mr. Val Moran:

There are a range of issues in regard to premises. As the Deputy will be aware, in the current system, there are HSE-owned premises, developer-owned premises and GP-owned premises. These are primary care centres that are well set up with a variety of different systems in place. With regard to the contractual position, the contractor basis is the preferred model. There are employed GPs within general practice. They are working with other GPs. Most of the studies show that while initially some GPs want to work as an employee, they later want to set up in practice. It is very difficult to see how two different models could exist side by side.

On the premises point and the system operating on a contractor basis, the support that would be there would be welcome. Previously, GMS premises were often provided free of charge, but that was a part of the work to get a GP into an area. That took away that cost. There are a significant number of GPs who have invested in their practices heavily over the years. That would need to be taken into account when looking at something like this. If that were the case, it is something that should be looked at. There is a difficulty sometimes with primary care centres getting GPs in because there is a rent to be charged by the HSE to the GP and then the GP is working in another premises down the road. Obviously, that does not make sense.