Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I welcome the witnesses and thank them for their presentation. It strikes me there is quite a serious mismatch between the professional body and the representative union for GPs. They are very often not on the same page on key issues, particularly the contract and the model of care. I have long been of the view that the GP contract is not fit for purpose. It is a 40-year-old contract, and while there were some amendments to it last year, it is very outdated. We know from various pieces of research that have been done over the years that younger GPs do not want to work in single-handed practices. We know they want to work as part of a multidisciplinary team. They do not want to be forced into a situation where they have to become business people and set up their own premises. The contract does not support that unless somebody has capital behind them. The model of care desperately needs to be updated. It does not provide for the multidisciplinary team approach. It does not provide for a greater role for practice nurses or advanced nurse practitioners. That skill mix needs to be updated. It is very difficult when the professional body is proposing one thing and the union seems to be holding back some of the modernisation required. Premises especially are a huge issue for newly graduating GPs. It is certainly my experience, from talking to many of them over the years, that they are not in a position to set up their own practice, nor do they want to do that, because they do not believe that is best practice. However, when it comes to the State providing primary care centres, there is huge opposition. That is why I am saying there is a complete mismatch between the objective of having GPs in multidisciplinary teams and there being resistance to allowing that model.