Dr. Martin Daly:

Absolutely. If an elderly person who smokes has an X-ray and it appears there may be a lesion in his or her chest, the radiographer will suggest undergoing a CT scan. However, because he or she does not have the capacity to perform a CT scan, the patient will be sent to a chest clinic in Galway. That is the reality.

The suggestion has been made that doctors have always emigrated. That was true before 1972. GPs left Ireland because there were no opportunities in the dispensary service, but hey came back in their droves with the advent of the GMS scheme in 1972 and the new contract. They came back because it was a new service. That generation of GPs have reached retirement age and there is no one to replace them. We need a new GP contract. It is complacent, therefore, to say the modern generation of doctors leaving the country are coming back; they are not. They are being offered better structured careers with better remuneration almost everywhere else in the western world. That is the truth and they are voting with their feet. It is not true to say we are replacing doctors like with like. We are going to have a major problem with access to general practitioner services in the very near future. The overall plan is to drive people into centres of population of 3,000 to 5,000 and everything in between will be lost in the constituencies of the Deputies present.