Mr. Bernard Gloster:

I would start with my earlier comment to the Senator’s colleague. We have to accept that we just do not have enough general practitioners for the demand and the needs of our population. We cannot put it in any other way. It is very easy for me to say that but the question is what am I doing about it? Over the last ten years, there has been a substantial increase, particularly going into this year, of the number of GPs going into training. It is in excess of 250 going into what we call first year of the programme. They are already qualified doctors so they make a contribution while they are in training. The total number of people in training will be more than 900. By 2026-2027 we would be aiming for 350 to be in on every year of the cycle which would be 1,200. Rural areas are very challenged as well as areas of disadvantage in parts of inner cities, so we have to target both. Already this year, at the end of the second quarter, 50 doctors have come in predominantly from South Africa. They are very good, well-qualified doctors. They are allowed to work here under what is essentially a form of supervision. After two years, subject to certain criteria with the Irish Medical Council, they can be registered as GPs. We have to give them some choice, to be fair, and we cannot dictate to them that they must go to west Clare, Belmullet or anywhere else that is challenged but we try to target them. I was communicating with a doctor in the Beara Peninsula in the last few days who is hoping to secure the entry of a doctor from South Africa to take up post there. That is the part about adding to the supply. We will be challenged beyond that in our capacity to train doctors. When doctors are in training they require training places and placements and so do all the other specialties. A GP trainee will typically spend two years on rotation in a number of specialties in the acute hospital system but for the consultants who are training them, there are also demands on them from the doctors aspiring to be consultants. It is a stepped approach but the increase in the training places this year is a very substantial intervention. It is not enough but it is the right direction.