Mr. Stephen Mulvany:

I have a couple of things to say. This is a perennial problem. That is accepted, as other Deputies have said. The longer term solution is a combination of investment in capacity, process improvement and integrated care, which is effectively the roadmap set out in Sláintecare. We are very clear on that. It happens every year, although it does not happen as badly as this year every year. The respiratory syncytial virus, RSV, which impacts the younger population in particular was much worse this year. It arose earlier than it had for a number of years and was much more sustained. Why did we not kick in the GP piece? There is a difficult part to this. In fairness to GP colleagues, even before the additional hours were put in, they were stretched in terms of time.

To come back to the question of what can sustainably be put in place earlier, GPs responded effectively even though they were struggling for staff. Ultimately, the reason only half signed up for the additional hours is mostly because they do not have the staff or capacity to do so. At one level, it took an element of crisis for us to get that whole-of-system response, including the additional GP hours. It is not as if the GPs were doing nothing. Could it be turned on earlier? That will be part of the lessons learned. Could we be ready to switch it on? Perhaps, if we reach a certain trigger level. One of the big issues for us is determining what should trigger these types of responses.