Mr. Bernard Gloster:

On the contracts, perhaps my colleagues, Mr. Healy and Mr. Flanagan, can comment on the detail on the pharmacy or dental contracts.

On the primary care centres, yes, they are vast and varied in terms of what is in them and what they do. It depends on the configuration of services that was there before the centre was built, how many GPs sign up from local practices to come in and work in the centre and how many of the enhanced community care staff have been recruited and deployed. In some places, we are running out of space with primary care centres and in other places we might be challenged to fill it all of the time. Primary care centres are more challenged now because they are based on an investor model usually. We have leased them back over 25 to 30 years. While we would be considered a blue-chip tenant in that context, the cost of construction and return on investment now is certainly impacting the number of people putting their hands up to develop primary care centres. That is something we are looking at.

Seven-day working has been in the news. Since I first came in, I have made it a priority to change how the health service is deployed. A big part of the health service is deployed on what we call a five-over-five basis, that is, a person is employed to work Monday to Friday. We need to move that to a five-over-seven basis so that we do not just have nursing and on-call medical services at the weekend and we actually have service delivery. We saw incontrovertible evidence of how that worked over the June bank holiday weekend when I asked people to voluntarily move into that space. Does it mean the whole 140,000 people in the health service would be required to work over seven days? No. Primarily, it is targeted at three categories of people: the people who would be required in hospitals to support decision-makers, particularly diagnostics; the services that would be required in the community to help people to avoid going to the hospital, which is primary care; and, more importantly, those who facilitate people being discharged. We had record discharges on Saturday and Sunday of the June bank holiday weekend, which meant that on Tuesday morning, the health system was not falling over in respect of trolleys. We were still challenged, but substantially less than we have been for some time. It is targeted at a number of disciplines and grades.

On expanded GP hours, the challenge is, with the number of GPs we have, with the demand from the public and, like the Deputy said, with appointments now going out several days in some practices, it is difficult to see how we would expand routine GP services into the evenings. It is a matter of practitioner choice. We are increasingly attempting to expand the GP out-of-hours options. We did a test at the bank holiday weekend, which we will build on. In one of the out-of-hours GP services, we made the diagnostics that would be available between Monday and Friday to GPs available over the weekend. We are looking at building up all of those other supports to try to attract GP out of hours to provide a greater level of service.

Five over seven is a target for the healthcare workforce, so the headline is correct; we are after that.