Dr. Brendan O'Shea:

There are two main reasons in our collective opinion. The first, regrettably, is that the political process has not served these patients. There has not been clarity and effective action at a political level to legislate appropriately. We have brought a lot of research with us today, and some great works of fiction. We have brought former Minister Deputy Brendan Howlin's cardiovascular strategy from 1999, which stated that there would be echo cardiography and BNP testing for all GPs. None of that has happened.

Another whopper is former Minister Deputy Micheál Martin's quality and fairness in primary care strategy. It is excellent policy, but none of it has translated. A nice way of saying it is that it is a sub-optimal political process. I do not think the former Minister, Senator James Reilly, got to write a glossy document.

We do not have a policy deficit. We have quite good policies but there has been a failure to legislation and it is by legislation that we will change the system, not by lobbying. Those of us in general practice have done a good deal of complaining, but we recognise that will not serve the patient either. We have to legislate. That is one of the reasons care has not been provided and chronic disease management has not been rolled out.