Dr. John O'Brien:

I reiterate a lot of what has been said. This brings me back to the business of holistic care. In the main, depression does not fall out of the sky. Generally speaking, people are depressed for reasons which are immediately clear. This is not be true in all cases, but it is true in many. Certainly, the social circumstances of the individual will have an impact on his or her psychological state. As to how that all plays out, two particular pressure areas in general practice are emerging. The first is deprived urban areas where the resources are just not there and the second is rural practice. Rural practices are shutting because they are not economically viable and large swathes of the countryside are without GPs. Patients use GPs in a manner which is not just about the ordinary taxonomy of diseases we were all taught in medical school. There is a lot more that transacts within a general practice than that. This part of what Senator Swanick refers to - loneliness. The loss of those critical services within communities is where all that stems from. The Chairman was involved in the "No Doctor, No Village" campaign. It is the critical end of things. The people who get the raw deal out of all of this every time with health are poor people. They have twice the problems of the rest of the community but they get the same level of allocation. That means they get half the service. I find that hard to stand over.