Dr. Mary Favier:

I wish to address the issue of cross-agency training, which would be very welcome. There is great potential for cultural awareness training on many issues, not just those concerning Travellers. It would be appropriate in many different fora. However, the best evidence would have to be applied. That evidence shows that this training should always be provided using resources delivered by those who are affected, in this case Traveller groups themselves. In any other niche type of education, the evidence always indicates that this is how the education is best provided, whether in the context of an undergraduate setting, GP training or in postgraduate education in which the ICGP is involved.

I also refer to the issue of accommodation and resources. I have been involved in Traveller health for the best part of 20 years as a GP. I can attest that accommodation issues have been front and centre in the past five to eight years. It has so much to do with housing, but it is also about austerity in a wider context. Resourcing issues are manifest in a lack of GPs, with new GPs leaving and not enough being trained. As a result there is a shortage of appointments. Vulnerable patients, who are more likely to need walk-in services or may default from an appointment and need to be offered another one in a timely fashion, can no longer be accommodated. Patients wait a week to get an appointment with me. There is very little flexibility because of a shortage of GPs and a shortage of training. Other austerity measures, for example, concerning medical cards have disproportionately affected Travellers. The validation of medical card lists is done in a broad sweep. A cardholder can receive paperwork with which to check his or her medical card even though it was renewed and a new plastic card issued only three months previously. This disproportionately affects Travellers who do not receive the correspondence.