Dr. Ray Walley:

I agree with the point that people are not allowed to be different any more. Some of my patients are just different and it would be very boring if everybody was the same. As their GP, they have known me for a long time. I give them the same advice about exercise and diet and the majority are not on medication. Because they are given this advice by a professional, they are very relaxed about it. Nuffield, a non-governmental organisation in the UK, looked at this issue following allegations that more prescribing was taking place and it decided that it was a good thing, as it meant people came early with mental health issues and that is what we want.

There are criteria under which one prescribes medication and one takes people off after a certain length of time but modern life is tough. There are difficulties and that results in mental health issues. They have been particularly evident during the ten years of the financial crisis in Ireland and the UK. Professional journals provide evidence that the increase in prescribing was not unique to Ireland and the UK but also happened in America. People are better educated and come to primary care and GP-community care more easily so we are giving more medication but we are also taking more medication away. We are trying to get people to be more exercise-conscious because that can lead to a massive improvement in mental health.

I am a GP in the inner city and there is a lack of opiate services, with only 35 detox beds for a country of 4.7 million people, which is crazy. Ritalin is a controlled drug and is consultant prescribed, meaning GPs do not prescribe it without it being reviewed by a clinic. I am an interviewer on one of the HSE panels and we are often lucky to have applicants because there are many posts for which there are no applicants. I trained in the UK and came back to apply for my post in north Dublin as one of 72 applicants. I came in at No. 4 but the people ahead of me were older and decided not to come back. We train excellent graduates which other countries want. Companies trying to recruit for the UK, Canada or wherever do not come here to interview potential GPs or consultants. They go to Australia instead, as they can meet more Irish young doctors in Australia, New Zealand or Canada than here.

Dr. Sadlier will give his opinion on cannabis. As a GP who has been qualified for 30 years, I am concerned about the legalisation of cannabis as it is a major carcinogen, with a higher tar content than cigarettes. It is especially dangerous in the adolescent brain and while there are medical uses for medicated cannabis, as somebody working in a deprived area I can say that evidence-based medicine is not there. If there is evidence-based medicine and there are uses for it, it would need to be reviewed.