Dr. Mark Murphy:

I will address Deputy Browne's point. As a thought experiment, let us say that there are 2,000 General Medical Services, GMS, lists out there. If there are too few general practitioners, GPs, and someone returning from Australia wants to start as a GP and picks a town in rural Ireland, an inner city deprived area or anywhere that does not have one, what would logically happen? A wonderful thing happened a few years ago, in that the GMS lists were opened up. That was long overdue. I can now get a GMS list. Starting on zero patients, my overheads for a premises, staff and equipment would be astronomical and my income would be zero in the first year. We need more GPs. Dr. Noonan has taken over a new list and I am thinking of doing the same, but what we really need is for GPs to set up from scratch and take on patients when more persons enter the system and get GP access cards. That is a major risk, though. There is no capital for GPs to do this. While it is great that the medical card system has opened up, in reality only a handful of my friends throughout the country have done so because it is financially the most loss-making decision that one could ever make for one's family. GPs have done it only to emigrate. We need to consider capital incentives for this situation. That is important. If a premises is rent free, for example, it makes a great deal of sense. If a GP can take over a premises and pay the rent, that will also be okay. We do not need to have a fixed position on that issue, but we need to support that GP from a capital point of view so that he or she can work in that environment. We will not get GPs setting up de novounless this happens.