Dr. Ray Walley:

We also need to learn lessons from the United Kingdom where they have a nine-to-five contract. All their funding, 10% of the budget, goes to a nine-to-five contract. Ours goes to a 24-7 contract. In the UK the problem is that when general practitioners gave up the out of hours service, they lost control of the out of hours system so there was no continuity. As a result of that, two thirds of all out of hours consultations are done by people flying in to do shifts. We still have continuity care.

One of the findings from the Francis report in Mid Staffordshire Hospital about two years ago, was an estimate - the sad thing is that it is an estimate, because they cannot even be specific - that up to 1,500 people passed away in terrible, atrocious conditions where the care was substandard. As a result of that they brought in a system whereby one would have a named GP for everybody over 75. We still have a named GP system here, whereby matters come out to a specific GP. Even though we are getting a quarter to one fifth of the resources, the level of care we are providing is as good, but we want a modern contract.

A professor of general practice recently came from the UK to take up a job in Cork. He complimented without qualification the general practice in this country because the strength of it is the personalised continuity of care. It needs to be resourced, however, or else we will lose it. The young will not take the abuse that other doctors have had over the years. They will walk away and will not stay.