Dr. Liam Mac Gabhann:

One of the challenges is that when Joe or Josephine Soap on the street is asked what primary care is, the answer is that it is the GP. GPs are private operators doing the best job they can with the resources they have and the limits of the number of people in the profession. They will want to know where to refer somebody who is coming with a dual diagnosis. Where the GP refers the person and how are their needs are met are the issues. I hope we have given some examples of where they can be met. Primary care is a brokerage at the moment. This is not to say that is what it was meant to be but that is the case now and we need the brokerage to be able to move people through the general practice onwards to whatever organisations are dealing with the issue. That is the reality of much primary care at present.