Michael Harty (Clare, Independent)
Link to this: Individually | In context | Oireachtas source

I thank the witnesses for having come in. I must declare, I am a member of the Irish College of General Practitioners and have been since its foundation in 1986. It has brought general practice out of the dark ages and into the 21st century and has been essential for the development of general practice. It is involved in education, standards and research and training. It is not involved in negotiating contracts, as Dr. Murphy has said. I also compliment the ICGP on having brought young GPs in because we are seeing a profession whose members are ageing and it is good to see young GPs coming in and staying in Ireland.

The most important aspect of general practice is the continuity of care that GPs provide to their patients. We know their medical illnesses but we also know their psychological, social and financial backgrounds, which are all very important components of general practice. Continuity of care is a critical component of general practice, and we want to maintain that. Our first difficulty is that general practice and primary care are not properly funded. Our second difficulty is that even if we were properly funded, there would still be a huge gap between the integration of primary care with secondary care. We have heard of the Kilkenny model, which is working superbly, and it has been asked why all GPs and hospitals are not engaging. It is a wonderful question because we should be engaging and there should be huge communication between primary care and secondary care. That is the purpose of this committee, apart from bolstering primary care, namely, to bring about a situation of being able to integrate primary care and secondary care. It is a terrible term, but there should be a seamless transition between primary and secondary care. General practitioners look after their patients for 99% of their time. In their lifetime, 1% of patients' time or even less may be spent in a hospital. They go to hospital and they come back to us. We are the people who look after them in their multi-morbidity state, and it is important to state that GPs look after multi-morbidity. Patients go to the diabetic clinic and get tablets from that. They go to the heart failure clinic and get tablets from that. They go to all these clinics, and we are the people who integrate.

The solutions to our problem in devising a new system are recruitment and retention, increasing our bed capacity and increasing our access to diagnostics. All three are work practices, and GPs as well as consultants must alter their work practices.