Dr. Mary Flynn:

I will reiterate Dr. Fawsitt's comment. A question was asked about how Sláintecare can be implemented. We only know the primary care part. We need the Department of Health and the HSE to embrace it and then for the general practice bodies, namely, the ICGP, the NAGP and the IMO to be involved. This cannot be implemented by HSE managers or anyone else. This has to be done in partnership with the people on the ground who know they system and how it works. It is really important for the general practice professional and representative bodies to be involved with the Department of Health and the HSE in making a start on this. A contract is essential and it must be negotiated with all representative bodies. If the bulk of GPs are to be brought along with wherever we are going with the contract, the GPs must feel they have been represented in the process. It must be a contract that has been negotiated by both bodies. While we cannot have a big bang and something set out in stone on day one, we still need a rough guide as to where it is going in order to keep Dr. Ó Tuathail and his generation here. The problem is one of uncertainty. There is massive uncertainty over what is happening. Will there be free GP care for all? Will we be nationalised? There is a total lack of understanding among this generation of newly qualified GPs as to what their life will be like in ten years' time. We need a contract, or the basis of a contract, that will give some clue about that.

The aspiration of Sláintecare is free access to primary care and general practice for all patients. While that is a very admirable end point, perhaps "free" is the wrong word, and maybe it should be in some way limited. We are very far from being anywhere close to being ready for that unless we can get the Department, the HSE and the bodies in the room to get talking about the contract and how that will evolve. That will get the GPs who are qualifying interested in getting involved and staying. Until we do that, we will not get anywhere with Sláintecare.