Brian Stanley (Laois-Offaly, Sinn Fein) | Oireachtas source

I will allow the Deputy in a second time.

The first issue I wish to raise relates to out-of-hours GP services. Last year, we dealt with the issue of SouthDoc services being closed in a couple of locations without much warning to the public. The provision and cost of those services were raised. On 23 December, people in Laois-Offaly and Longford-Westmeath in the midlands, which is the area I am in, noticed that a company limited by guarantee would be pulling the plug on its services within a week. I heard about this on Christmas Eve. A few facts have been discovered since.

I acknowledge the efforts of local HSE management to try to put an interim solution in place. It was dealing with a very difficult situation.

There are 17 providers and six different models throughout the State. The cost for 2021, insofar as I can extrapolate it from the documents the witnesses supplied for today, is €55 million. There is a service support cost of €26 million. In 2022, an extra €10 million was provided for out-of-hours GP services under the winter plan. Therefore, according to Mr. Mulvany's figures, it would be safe enough to assume that the cost of the service is between €90 million and €100 million per year. The situation is that there was reliance on a private company. It engaged with the HSE for a number of months before closure. As I understand it, the engagements might not have been what they needed to be, and then the plug was pulled. The problem is that we are left with a collapse in essential services at the same time that emergency departments and hospitals are overloaded. A member of my family needed to see a doctor but finished up in an accident and emergency unit and in hospital for six days. They would not have needed to be in hospital for six days had their condition been caught in time over the Christmas period. This is the kind of difficulty being caused. Some GPs in the region may not have been paid for the services they provided at different times through the model we have.

I ask Mr. Mulvany to keep his answers short. I do not want to be rude to him but I want to try to get to the bottom of this. There are six different models. The system basically grew in an ad hocway. I raised this with the Taoiseach, who is a GP, and he acknowledged it. The cost is in the region of €90 million to €100 million per year.