Dr. Cathal O'Donnell:

I thank Deputy Ó Caoláin for his question which relates to an interesting finding from the capacity review. We had expected that there would be a difference but we were slightly surprised at its magnitude. In the UK, and in England in particular, in terms of emergency and unscheduled care over the last ten years, there were issues with out-of-hours access to GPs and they put in place a number of different initiatives to address that problem, including urgent care centres, walk-in centres, minor injury units and NHS Direct, which was a telephone advice service which did not work out very well. That service has now been reinvented as the 111 service. All of that meant confusion for the average member of the public who had a medical problem. People did not know what was the correct pathway for them so they reverted to what they were comfortable with which was either ringing 999 or attending a hospital accident and emergency department. That goes a long way towards explaining the difference. Members of the public in the UK tend to dial 999 more for issues now than they would have done in the past because the correct pathway for them was unclear.

The second issue is that in rural Ireland in particular, people tend to ring their GP even when they should not do so but should call an ambulance, perhaps because they have a good relationship with him or her. GPs are very good at recognising that and will often divert such patients and the GP co-ops would often transfer such calls to us. I think that explains the difference in the context of the 40% finding, which is in stark contrast to the situation in the UK.