Dr. Tadhg Crowley:

The Deputy made a point on the GP nurses. They are part of the GP team. We hear in hospitals about the consultants and their teams and we are now in a position where we talk about GP teams. These people who work with GPs in practices contribute hugely to the functioning of GP practices. We were talking earlier about allowing a general practice to change its subsidies to allow us to take on people, such as allied health professionals and healthcare assistants, depending on the area of need that we perceive is required for the practice. These will allow the GPs - the senior clinical decision-makers within our ecosystem, as Dr. Quinlan calls it - to make decisions that will be best for the patients. The nurses have employment contracts and we liaise closely with nursing unions and GP practice bodies on terms of employment but, ultimately, the GP is still the employer.

The Deputy made a great point on training abroad. He was abroad himself on Erasmus. I worked in Australia for a year and learned a huge amount about a different system and then came back and brought it with me. That has been the tradition for Ireland since time immemorial. The problem now is that the systems over there are very good to work in and people are not returning. That is a very important point. When we go back to the figures we had, of the GPs who go abroad, it is very hard to estimate prospectively how many people will stay abroad. In terms of the study that the ICGP trainees did in 2019, before they left 9% of them had already planned to go abroad and how many will return is a serious issue going forward.