Dr. John O'Brien:

The question of drugs versus talk therapy is probably the nub of what we are discussing today. As we observed in our submission, drugs are not good or bad; they just are. They are a tool that is useful when they are useful but not useful where they are not. The evidence for the use of antidepressants in mild to moderate depression is not good and there is no getting away from that. The evidence for the use of drugs in moderate to severe depression is very compelling but those boundaries are not fixed. They require the assessment and judgement of the GPs to establish where those boundaries are.

Depression, which is what we appear to be concentrating on a lot here, takes time. One needs time to hear a person, to let them tell their story, to evaluate it, to be upset, and to get a sense that the GP is interested. Patients often bring physical complaints into the conversation too, and they must also be addressed. As was laid out in the vignette earlier, it is a complicated and time consuming thing.

Because of the cutbacks that have been engendered in general practice, which I keep returning to, consultation times have shrunk. As a consequence, people are under pressure to leave out things that they really want to bring into the equation. It is not the case that one treatment is good and the other is bad, each has its place, but if GPs are not provided with the time to do the job that they do, then unfortunately, one ends up in a situation where they are backed into a corner.