Dr. Tadhg Crowley:

I will come in on primary care centres. I work in a primary care centre. It was a self-developed primary care centre whereby eight GPs came together in 2003-04 and got involved in the development of the centre. We learned an awful lot of what can go wrong and what will go wrong and we came out the other end. It is clear from what happened since that there will no longer be GPs self-developing, which is a pity. The Indecon report produced a number of findings which, if followed through, would result in GPs being willing to develop their own centres for the needs of their population.

In terms of the primary care centres developed by developers, they are now facing this situation of the rent, the property and the management. I get a lot of calls because we did our own centre. In speaking to a number of colleagues about ongoing management fees, one would definitely need a business degree to cope with some of the hidden snags that exist for GPs. Having listened to people's stories, GPs were burned. It worked out for us but there were other GPs for whom it did not work out. It has moved away from GP developers to developer-led primary care centres. There are issues in terms of how the payments occur. It goes back to what we were talking about before. I am sorry for taking up so much of the committee's time. We will have to look at the infrastructure for GPs and make allowances according to that. It is well worth looking at the Indecon report.