Dr. Pádraig McGarry:

On the question the Chairman asked about investment in general practice, as the Chairman stated, it is quite clear that a euro invested brings a fivefold return into the secondary care. Certainly, that was one issue we always have had in mind when we went to discuss chronic disease management within the negotiations. I am glad to see that movement has come on that, whereby we have an agreed set approach to managing patients who probably are more appropriately to be seen in general practice as opposed to secondary care. There has been investment in chronic disease management, which will roll over the next number of years. It is expected that should be ready in January but that will depend on a functioning IT system at that time. The Chairman will be aware that will bring great benefits to patients.

Further investment is needed as not only does one need chronic disease management, one needs the allied services such as the public health nurses, the practice nurses, the dietitians etc. who will be able to make that function. That certainly is in the plan. Hopefully, it will be acted on. The Chairman touched on it earlier in reference to access to diagnostics. If it can be done in general practice at an appropriate level, of course that will be efficient and give pay back.